{Reference Type}: Journal Article
{Title}: Capillary refill time assessment after fluid challenge in patients on venoarterial extracorporeal membrane oxygenation: A retrospective study.
{Author}: Hariri G;Luxey X;Wenger S;Dureau P;Hariri S;Charfeddine A;Lebreton G;Djavidi N;Lancelot A;Duceau B;Bouglé A;
{Journal}: J Crit Care
{Volume}: 82
{Issue}: 0
{Year}: 2024 Aug 9
{Factor}: 4.298
{DOI}: 10.1016/j.jcrc.2024.154770
{Abstract}: <B>BACKGROUND: </B>Monitoring fluid therapy is challenging in patients assisted with Veno-arterial ECMO. The aim of our study was to evaluate the usefulness of capillary refill time to assess the response to fluid challenge in patients assisted with VA-ECMO.<BR><B>METHODS: </B>Retrospective monocentric study in a cardiac surgery ICU. We assess fluid responsiveness after a fluid challenge in patients on VA-ECMO. We recorded capillary refill time before and after fluid challenge and the evolution of global hemodynamic parameters.<BR><B>RESULTS: </B>A total of 27 patients were included. The main indications for VA-ECMO were post-cardiotomy cardiogenic shock (44%). Thirteen patients (42%) were responders and 14 non-responders (58%). In the responder group, the index CRT decreased significantly (1.7 [1.5; 2.1] vs. 1.2 [1; 1.3] s; p = 0.01), whereas it remained stable in the non-responder group (1.4 [1.1; 2.5] vs. 1.6 [0.9; 1.9] s; p = 0.22). Diagnosis performance of CRT variation to assess response after fluid challenge shows an AUC of 0.68 (p = 0.10) with a sensitivity of 79% [95% CI, 52-92] and a specificity of 69% [95% CI, 42-87], with a threshold at 23%.<BR><B>CONCLUSIONS: </B>In patients treated with VA-ECMO index capillary refill time is a reliable tool to assesses fluid responsiveness.<BR><B>METHODS: </B>Critical care, Cardiac surgery, ECMO.