Capillary Refill Time: A Vital Sign for Nurses in Sepsis Management

Abstract

Capillary refill time (CRT) is a non-invasive marker of peripheral perfusion that plays a crucial role in the management of critically ill patients, particularly those with sepsis. This narrative review, adhering to PRISMA guidelines, investigates the reliability and clinical significance of CRT in sepsis care. CRT assessments are influenced by factors such as age, sex, temperature, lighting, and measurement techniques. Inconsistencies in CRT implementation and interpretation among healthcare professionals highlight the need for standardized protocols and comprehensive training to minimize variability and enhance reliability. While there is no universally accepted cutoff value for normal CRT, studies suggest that CRT > 2.5-3 seconds indicates impaired tissue perfusion and is associated with adverse outcomes in sepsis patients. CRT serves as a warning sign for severe infections, a triage tool for identifying patients at risk, and a marker of tissue hypoperfusion. It correlates with microcirculatory parameters and lactate levels, reflecting the presence and severity of shock. CRT-guided fluid resuscitation strategies have shown promise in reducing organ dysfunction and mortality compared to lactate-targeted approaches. Persistent abnormal CRT post-resuscitation signifies a severe clinical phenotype with greater organ dysfunction and lower survival rates. To optimize the clinical application of CRT, healthcare providers should use standardized measurement techniques in appropriate patient populations while considering ambient factors. As a qualitative and quantitative measure, CRT serves as a critical tool for early detection of tissue hypoperfusion, guiding resuscitation efforts, and predicting outcomes in sepsis management.