?? Paper of the day
Prashant Nasa
Intensivist-Anaesthesiologist II Editor: Rational use of IV Fluids in Critically ll PROVE Network -Delphi Methodology II Fluid and Oxygen are Drugs
Monitoring capillary refill time in septic shock
Published in Intensive Care Medicine
Summary:
This editorial discusses the importance of monitoring capillary refill time (CRT) in septic shock and other critical conditions, emphasizing the need for standardized measurement techniques and the potential use of CRT as a resuscitation target.
Key takeaways:
1. CRT is a costless and dynamic parameter that rapidly responds to hemodynamic interventions, making it a suitable bedside tool for monitoring and guiding septic shock resuscitation.
2. Prolonged CRT after initial fluid resuscitation is associated with organ failure and increased mortality, while rapid normalization of CRT is linked to lower mortality, supporting its use for triage decisions.
3. CRT assessment may help tailor fluid and vasoactive drug administration and reveal the status of macro-to-microcirculatory coupling.
Counter arguments:
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1. The lack of specific guidelines for standardized CRT estimation may lead to variability in measurements and reliability, requiring mandatory training and standardization.
2. The use of CRT as a resuscitation target requires further validation through ongoing trials and standardization of the acquisition technique.:
This editorial discusses the importance of monitoring capillary refill time (CRT) in septic shock and other critical conditions, emphasizing the need for standardized measurement techniques and the potential use of CRT as a resuscitation target.
?? takeaways:
1. CRT is a costless and dynamic parameter that rapidly responds to hemodynamic interventions, making it a suitable bedside tool for monitoring and guiding septic shock resuscitation.
2. Prolonged CRT after initial fluid resuscitation is associated with organ failure and increased mortality, while rapid normalization of CRT is linked to lower mortality, supporting its use for triage decisions.
3. CRT assessment may help tailor fluid and vasoactive drug administration and reveal the status of macro-to-microcirculatory coupling.
Counter arguments:
1. The lack of specific guidelines for standardized CRT estimation may lead to variability in measurements and reliability, requiring mandatory training and standardization.
2. The use of CRT as a resuscitation target requires further validation through ongoing trials and standardization of the acquisition technique.
Professor of Medicine at Sorbonne University | Cardiologist & Intensivist at Saint-Antoine Hospital (APHP) | Head of Research Team U970 at Inserm PARCC | Co-founder & Chief Scientific Officer at POLYGON Therapeutics
8 个月Clinical evaluation of peripheral tissue perfusion is very helpful at bedside Great collaborative review with Glenn Hernandez