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J Vis Exp. 2017 Dec 2;(130). doi: 10.3791/56737.

Diffuse Reflectance Spectroscopy: Getting the Capillary Refill Test Under One's Thumb.

Author information

1
Department of Emergency Medicine, Local Health Care Services in Central Östergötland, Region Östergötland; Division of Drug Research, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University; Joakim.Henricson@regionostergotland.se.
2
Department of Emergency Medicine, Local Health Care Services in Central Östergötland, Region Östergötland; Division of Neuro and Inflammation Science, Department of Clinical and Experimental Medicine, Linköping University.
3
Division of Cell Biology, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University; Department of Dermatology and Venerology, Heart and Medicine Center, Region Östergötland.
4
Department of Emergency Medicine, Local Health Care Services in Central Östergötland, Region Östergötland; Division of Drug Research, Department of Medical and Health Sciences, Faculty of Health Sciences, Linköping University.

Abstract

The capillary refill test was introduced in 1947 to help estimate circulatory status in critically ill patients. Guidelines commonly state that refill should occur within 2 s after releasing 5 s of firm pressure (e.g., by the physician's finger) in the normal healthy supine patient. A slower refill time indicates poor skin perfusion, which can be caused by conditions including sepsis, blood loss, hypoperfusion, and hypothermia. Since its introduction, the clinical usefulness of the test has been debated. Advocates point out its feasibility and simplicity and claim that it can indicate changes in vascular status earlier than changes in vital signs such as heart rate. Critics, on the other hand, stress that the lack of standardization in how the test is performed and the highly subjective nature of the naked eye assessment, as well as the test's susceptibility to ambient factors, markedly lowers the clinical value. The aim of the present work is to describe in detail the course of the refill event and to suggest potentially more objective and exact endpoint values for the capillary refill test using diffuse polarization spectroscopy.

PMID:
29286408
PMCID:
PMC5755519
DOI:
10.3791/56737
[Indexed for MEDLINE]
Free PMC Article

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