Portable measurement device to quantitatively measure capillary refilling time

Shinozaki, Masayoshi; Shimizu, R.; Saito, Daiki; Nakada, Taka‐aki; Nakaguchi, Toshiya

doi:10.1007/s10015-021-00723-w

Cited by 4 publications

(4 citation statements)

References 35 publications

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“…16,18 As such, CRT is recommended in the 2021 guidelines for treating and managing sepsis. 1 This study developed a portable CRT measurement device 3,4 and evaluated the effect of vascular occlusion on CRT and the cut-off value of peripheral circulatory failure in the measurement device. The study hypothesized that CRT would be longer in AOT and VOT; however, CRT in AOT was significantly longer compared to CRT in No OT, and CRT in VOT was not significantly different from CRT in No OT.…”

Section: Discussionmentioning

confidence: 99%

“…The CRT in this study is calculated according to the definition from the time series data of nail bed color measured by the color sensor (Figure 1). 2,4 The developed device is manually operated to release, which may introduce spike noise into the time series data of the nail bed color. A Hampel filter was used to compensate for spike noise.…”

Section: Hampel Filtermentioning

confidence: 99%

“…3 The study in the past developed a portable CRT measurement device with a feedback function and demonstrated that the measured values were more stable than conventional visual CRT measurements. 4 To evaluate the effect of vascular occlusion on the CRT and the cut-off value for peripheral circulatory failure, this study induced peripheral circulatory failure by performing vascular occlusion tests, because the artery occlusion test (AOT) and venous occlusion test (VOT) result in the occlusion of peripheral blood flow and prolongation of CRT.…”

Section: Introductionmentioning

confidence: 99%

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Cut-Off Value of Capillary Refill Time for Peripheral Circulatory Failure Diagnosis

Shinozaki

Nakada

Saito

et al. 2023

Prehosp. Disaster med.

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Introduction: Capillary refill time (CRT) is an indicator of peripheral circulation and is recommended in the 2021 guidelines for treating and managing sepsis. Study Objective: This study developed a portable device to realize objective CRT measurement. Assuming that peripheral blood flow obstruction by the artery occlusion test (AOT) or venous occlusion test (VOT) increases the CRT, the cut-off value for peripheral circulatory failure was studied by performing a comparative analysis with CRT with no occlusion test (No OT). Methods: Fourteen (14) healthy adults (age: 20–26 years) participated in the study. For the vascular occlusion test, a sphygmomanometer was placed on the left upper arm of the participant in the supine position, and a pressure of 30mmHg higher than the systolic pressure was applied for AOT, a pressure of 60mmHg was applied for VOT, respectively, and no pressure was applied for No OT. The CRT was measured from the index finger of the participant’s left hand. Results: Experimental results revealed that CRT was significantly longer in the AOT and did not differ significantly in the VOT. The cut-off value for peripheral circulatory failure was found to be 2.88 seconds based on Youden’s index by using receiver operating characteristic (ROC) analysis with AOT as positive and No OT as negative. Conclusion: Significant results were obtained in a previous study on the evaluation of septic shock patients when CRT > three seconds was considered abnormal, and the cut-off value for peripheral circulatory failure in the current study validated this.

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Section: Discussionmentioning

confidence: 99%

Section: Hampel Filtermentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Cut-Off Value of Capillary Refill Time for Peripheral Circulatory Failure Diagnosis

Shinozaki

Nakada

Saito

et al. 2023

Prehosp. Disaster med.

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“…Studies have attempted to solve the standard CRT measurement problem (42,43). However, how to automatically adjust the compression time and force based on different factors, such as age, sex, and temperature, remains an urgent issue.…”

Section: Capillary Refill Timementioning

confidence: 99%

Hemorrhagic Shock Assessed by Tissue Microcirculatory Monitoring: A Narrative Review

Yao,

Chen,

et al. 2023

Shock

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Hemorrhagic shock (HS) is a common complication after traumatic injury. Early identification of HS can reduce patients’ risk of death. Currently, the identification of HS relies on macrocirculation indicators such as systolic blood pressure and heart rate, which are easily affected by the body's compensatory functions. Recently, the independence of the body's overall macrocirculation from microcirculation has been demonstrated, and microcirculation indicators have been widely used in the evaluation of HS. In this study, we reviewed the progress of research in the literature on the use of microcirculation metrics to monitor shock. We analyzed the strengths and weaknesses of each metric and found that microcirculation monitoring could not only indicate changes in tissue perfusion before changes in macrocirculation occurred but also correct tissue perfusion and cell oxygenation after the macrocirculation index returned to normal following fluid resuscitation, which is conducive to the early prediction and prognosis of HS. However, microcirculation monitoring is greatly affected by individual differences and environmental factors. Therefore, the current limitations of microcirculation assessments mean that they should be incorporated as part of an overall assessment of HS patients. Future research should explore how to better combine microcirculation and macrocirculation monitoring for the early identification and prognosis of HS patients.

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Feasibility study of wearable capillary refill time measurement device

Shinozaki,

Saito,

Nakada

et al. 2024

Artif Life Robotics

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Capillary refill time (CRT) is an internationally accepted indicator of peripheral circulation. The CRT is measured by applying compression to the fingernail for a few seconds, releasing it, and observing the process of refilling of blood at the fingertip. The international guidelines for the management of sepsis and septic shock 2021 contains an additional new recommendation for CRT measurement to determine the peripheral circulation statuses of adult patients with septic shock. However, the current CRT measurement method lacks objectivity. Previous studies have reported the development of measurement devices and video analysis systems, which involve complex measurement environment construction and assume only in-hospital measurements. In addition, since medical workers are limited in the number of carrying medical devices, devices that can be used to obtain multiple biometric indicators in a single measurement are needed. Hence, a prototype wearable CRT measurement device was developed in this study, and its feasibility was evaluated by comparing the agreement, intra-class correlation coefficient, and coefficient of variation with those of a CRT measurement device developed in the past. The results indicated that mean CRTs between measurement methods were agreement, with moderate or better intra-rater reliability and no difference in coefficient of variation. Therefore, the results indicate the feasibility of the proposed wearable CRT device.

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Portable measurement device to quantitatively measure capillary refilling time

Cited by 4 publications

References 35 publications

Cut-Off Value of Capillary Refill Time for Peripheral Circulatory Failure Diagnosis

Cut-Off Value of Capillary Refill Time for Peripheral Circulatory Failure Diagnosis

Hemorrhagic Shock Assessed by Tissue Microcirculatory Monitoring: A Narrative Review

Feasibility study of wearable capillary refill time measurement device

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