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The following is a summary of “Capillary refill time assessment after fluid challenge in patients on venoarterial extracorporeal membrane oxygenation: A retrospective study,” published in the August 2024 issue of Critical Care by Hariri et al. 

Researchers conducted a retrospective study to assess the effectiveness of capillary refill time in evaluating the response to fluid challenge in patients receiving Veno-arterial extracorporeal membrane oxygenation (VA-ECMO).  

They analyzed a study in a cardiac surgery ICU to assess fluid responsiveness in patients on VA-ECMO, measured capillary refill time before and after a fluid challenge, and analyzed changes in global hemodynamic parameters.  

The results showed 27 patients included, with post-cardiotomy cardiogenic shock being the primary indication (44%). About 13 patients (42%) were responders, while 14 (58%) were non-responders. In the responder group, the index Capillary refill time (CRT) decreased significantly (1.7 [1.5; 2.1] vs. 1.2 [1; 1.3] s; P=0.01), remaining stable in the non-responder group (1.4 [1.1; 2.5] vs. 1.6 [0.9; 1.9] s; P=0.22). The CRT variation’s diagnostic performance for assessing fluid challenge response had an AUC of 0.68 (P=0.10), with 79% sensitivity (95% CI, 52–92) and 69% specificity (95% CI, 42–87) at a threshold of 23.  

They concluded index CRT is a reliable tool for assessing fluid responsiveness in patients treated with VA-ECMO. 

Source: sciencedirect.com/science/article/abs/pii/S0883944124002570