Capillary refill time for the management of acute circulatory failure: a survey among pediatric and adult intensivists.


Journal

BMC emergency medicine
ISSN: 1471-227X
Titre abrégé: BMC Emerg Med
Pays: England
ID NLM: 100968543

Informations de publication

Date de publication:
18 07 2022
Historique:
received: 03 02 2022
accepted: 06 06 2022
entrez: 19 7 2022
pubmed: 20 7 2022
medline: 22 7 2022
Statut: epublish

Résumé

Recent studies have shown the prognostic value of capillary refill time (CRT) and suggested that resuscitation management guided by CRT may reduce morbidity and mortality in patients with septic shock. However, little is known about the current use of CRT in routine clinical practice. This study aimed to assess the modalities of CRT use among French adult and pediatric intensivists. A cross-sectional survey exploring CRT practices in acute circulatory failure was performed. The targeted population was French adult and pediatric intensivists (SFAR and GFRUP networks). An individual invitation letter including a survey of 32 questions was emailed twice. Descriptive and analytical statistics were performed. Among the 6071 physicians who received the letter, 418 (7%) completed the survey. Among all respondents, 82% reported using CRT in routine clinical practice, mainly to diagnose acute circulatory failure, but 45% did not think CRT had any prognostic value. Perfusion goal-directed therapy based on CRT was viewed as likely to improve patient outcome by 37% of respondents. The measurement of CRT was not standardized as the use of a chronometer was rare (3%) and the average of multiple measurements rarely performed (46%). Compared to adult intensivists, pediatric intensivists used CRT more frequently (99% versus 76%) and were more confident in its diagnostic value and its ability to guide treatment. CRT measurement is widely used by intensivists in patients with acute circulatory failure but most often in a non-standardized way. This may lead to a misunderstanding of CRT reliability and clinical usefulness.

Identifiants

pubmed: 35850662
doi: 10.1186/s12873-022-00681-x
pii: 10.1186/s12873-022-00681-x
pmc: PMC9290243
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

131

Informations de copyright

© 2022. The Author(s).

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Auteurs

Matthias Jacquet-Lagrèze (M)

Service d'anesthésie-réanimation, Hôpital cardiologique Louis Pradel, Hospices Civils de Lyon, 59, Boulevard Pinel, 69677, Bron Cedex, France. matthias.jacquet-lagreze@chu-lyon.fr.
Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon, Cedex 08, France. matthias.jacquet-lagreze@chu-lyon.fr.
CarMeN Laboratory, INSERM UMR 1060, University Claude Bernard Lyon 1, Lyon, France. matthias.jacquet-lagreze@chu-lyon.fr.
Service d'anesthésie-réanimation, Hôpital Louis Pradel, Hospices Civils de Lyon, 59, Boulevard Pinel, 69394, Lyon, Cedex, France. matthias.jacquet-lagreze@chu-lyon.fr.

Cléo Wiart (C)

Service d'anesthésie-réanimation, Hôpital cardiologique Louis Pradel, Hospices Civils de Lyon, 59, Boulevard Pinel, 69677, Bron Cedex, France.

Rémi Schweizer (R)

Service d'anesthésie-réanimation, Hôpital cardiologique Louis Pradel, Hospices Civils de Lyon, 59, Boulevard Pinel, 69677, Bron Cedex, France.
Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon, Cedex 08, France.

Léa Didier (L)

Service d'anesthésie-réanimation, Hôpital cardiologique Louis Pradel, Hospices Civils de Lyon, 59, Boulevard Pinel, 69677, Bron Cedex, France.
Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon, Cedex 08, France.

Martin Ruste (M)

Service d'anesthésie-réanimation, Hôpital cardiologique Louis Pradel, Hospices Civils de Lyon, 59, Boulevard Pinel, 69677, Bron Cedex, France.
Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon, Cedex 08, France.

Maxime Coutrot (M)

FHU PROMICE, DMU Parabol, Département d'anesthésie-réanimation, Hôpital Saint Louis, Assistance publique des Hôpitaux de Paris, Paris, France.
Faculté de médecine Paris, Université Paris France, Paris, France.

Matthieu Legrand (M)

Department of Anesthesia & Perioperative Care, Division of Critical Care Medicine, University of California, San Francisco & F-CRIN-INI-CRCT Network, Nancy, France.

Florent Baudin (F)

Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon, Cedex 08, France.
Service de Réanimation et Urgences Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, F-69500, Bron, France.

Etienne Javouhey (E)

Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon, Cedex 08, France.
Service de Réanimation et Urgences Pédiatriques, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, F-69500, Bron, France.

François Dépret (F)

FHU PROMICE, DMU Parabol, Département d'anesthésie-réanimation, Hôpital Saint Louis, Assistance publique des Hôpitaux de Paris, Paris, France.
Faculté de médecine Paris, Université Paris France, Paris, France.

Jean-Luc Fellahi (JL)

Service d'anesthésie-réanimation, Hôpital cardiologique Louis Pradel, Hospices Civils de Lyon, 59, Boulevard Pinel, 69677, Bron Cedex, France.
Faculté de médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon, Cedex 08, France.
CarMeN Laboratory, INSERM UMR 1060, University Claude Bernard Lyon 1, Lyon, France.

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