What is the significance of capillary refill time in the emergent management of pediatric patients with fever?

Updated: Jul 23, 2019
  • Author: Hina Z Ghory, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Answer

The capillary refill time is generally thought to be the quickest assessment of early hypoperfusion. Capillary refill time is faster to obtain than a blood-pressure measurement and is particularly helpful in a loud or busy ED. A delay in the capillary refill time (>2 seconds) indicates hypoperfusion of the skin. Shunting of blood from the capillary beds in the skin is an indication of increased systematic vascular resistance (SVR). An increase in SVR is generally thought to occur early in the course of pediatric hypovolemia. Hypovolemia can result from obvious conditions, such as blood loss and vomiting and diarrhea, or from more subtle reasons, such as tachypnea and sweating.


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