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.

中文翻译：

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治疗急性循环衰竭的毛细血管再充盈时间：儿科和成人重症医生的调查


最近的研究显示了毛细血管再充盈时间 (CRT) 的预后价值，并表明以 CRT 为指导的复苏管理可能会降低感染性休克患者的发病率和死亡率。然而，人们对目前 CRT 在常规临床实践中的使用知之甚少。本研究旨在评估法国成人和儿科重症监护医师使用 CRT 的方式。进行了一项横断面调查，探讨 CRT 在急性循环衰竭中的应用。目标人群是法国成人和儿科重症监护医生（SFAR 和 GFRUP 网络）。包含 32 个问题调查的个人邀请函通过电子邮件发送了两次。进行了描述性和分析性统计。在收到这封信的 6071 名医生中，有 418 名（7%）完成了调查。在所有受访者中，82% 的受访者表示在常规临床实践中使用 CRT，主要是为了诊断急性循环衰竭，但 45% 的受访者认为 CRT 没有任何预后价值。 37% 的受访者认为基于 CRT 的灌注目标导向治疗可能会改善患者的预后。 CRT 的测量没有标准化，因为天文台的使用很少（3%），并且很少进行多次测量的平均值（46%）。与成人重症医生相比，儿科重症医生更频繁地使用 CRT（99% 比 76%），并且对其诊断价值和指导治疗的能力更有信心。 CRT 测量被重症医生广泛用于治疗急性循环衰竭患者，但最常见的是非标准化方式。这可能会导致对 CRT 可靠性和临床实用性的误解。