Prognostic value of capillary refill time in adult patients: a systematic review with meta-analysis.

Autor: Jacquet-Lagrèze M; Service d'anesthésie-Réanimation, Hôpital Cardiologique Louis Pradel, 59 Bd Pinel, 69500, Hospices Civils de LyonBron, 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 Laboratoire, Inserm UMR 1060, Université Claude Bernard, Lyon 1, Lyon, France. matthias.jacquet-lagreze@chu-lyon.fr., Pernollet A; Service d'anesthésie-Réanimation, Hôpital Cardiologique Louis Pradel, 59 Bd Pinel, 69500, Hospices Civils de LyonBron, France.; Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon Cedex 08, France., Kattan E; Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.; The Latin American Intensive Care Network (LIVEN), Santiago, Chile., Ait-Oufella H; Hôpital Saint-Antoine, Service de Médecine Intensive-Réanimation, Sorbonne Université, Paris, France., Chesnel D; Service d'anesthésie-Réanimation, Hôpital Cardiologique Louis Pradel, 59 Bd Pinel, 69500, Hospices Civils de LyonBron, France.; Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon Cedex 08, France., Ruste M; Service d'anesthésie-Réanimation, Hôpital Cardiologique Louis Pradel, 59 Bd Pinel, 69500, Hospices Civils de LyonBron, France.; Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon Cedex 08, France.; CarMeN Laboratoire, Inserm UMR 1060, Université Claude Bernard, Lyon 1, Lyon, France., Schweizer R; Service d'anesthésie-Réanimation, Hôpital Cardiologique Louis Pradel, 59 Bd Pinel, 69500, Hospices Civils de LyonBron, France.; Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon Cedex 08, France., Allaouchiche B; Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon Cedex 08, France.; Service d'anesthésie-Réanimation, Hôpital Lyon Sud, Hospices Civils de Lyon, 165 Chem. du Grand Revoyet, 69495, Pierre-Bénite, France., Hernandez G; Departamento de Medicina Intensiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.; The Latin American Intensive Care Network (LIVEN), Santiago, Chile., Fellahi JL; Service d'anesthésie-Réanimation, Hôpital Cardiologique Louis Pradel, 59 Bd Pinel, 69500, Hospices Civils de LyonBron, France.; Faculté de Médecine Lyon Est, Université Claude Bernard Lyon 1, 8, Avenue Rockefeller, 69373, Lyon Cedex 08, France.; CarMeN Laboratoire, Inserm UMR 1060, Université Claude Bernard, Lyon 1, Lyon, France.
Jazyk: angličtina
Zdroj: Critical care (London, England) [Crit Care] 2023 Dec 02; Vol. 27 (1), pp. 473. Date of Electronic Publication: 2023 Dec 02.
DOI: 10.1186/s13054-023-04751-9
Abstrakt: Purpose: Acute circulatory failure leads to tissue hypoperfusion. Capillary refill time (CRT) has been widely studied, but its predictive value remains debated. We conducted a meta-analysis to assess the ability of CRT to predict death or adverse events in a context at risk or confirmed acute circulatory failure in adults.
Method: MEDLINE, EMBASE, and Google scholar databases were screened for relevant studies. The pooled area under the ROC curve (AUC ROC), sensitivity, specificity, threshold, and diagnostic odds ratio using a random-effects model were determined. The primary analysis was the ability of abnormal CRT to predict death in patients with acute circulatory failure. Secondary analysis included the ability of CRT to predict death or adverse events in patients at risk or with confirmed acute circulatory failure, the comparison with lactate, and the identification of explanatory factors associated with better accuracy.
Results: A total of 60,656 patients in 23 studies were included. Concerning the primary analysis, the pooled AUC ROC of 13 studies was 0.66 (95%CI [0.59; 0.76]), and pooled sensitivity was 54% (95%CI [43; 64]). The pooled specificity was 72% (95%CI [55; 84]). The pooled diagnostic odds ratio was 3.4 (95%CI [1.4; 8.3]). Concerning the secondary analysis, the pooled AUC ROC of 23 studies was 0.69 (95%CI [0.65; 0.74]). The prognostic value of CRT compared to lactate was not significantly different. High-quality CRT was associated with a greater accuracy.
Conclusion: CRT poorly predicted death and adverse events in patients at risk or established acute circulatory failure. Its accuracy is greater when high-quality CRT measurement is performed.
(© 2023. The Author(s).)
Databáze: MEDLINE
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