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Question 2 Is capillary refill time a useful marker of haemodynamic status in neonates?
  1. Chris Gale
  1. Registrar, Neonatal Transport Team, London and Clinical Research Fellow, Imperial College London, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK; christopher.gale@imperial.ac.uk

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While working for the neonatal transport team you are involved in the transfer of an extremely low birthweight preterm baby, 28 weeks' gestation, birth weight 800 g, on day 1 of life. The baby is ventilated with stable gases, minimal ventilator requirements and is not receiving any cardiovascular support. On clinical assessment you are concerned as the central capillary refill time (CRT) is prolonged at 4 seconds, despite normal cuff blood pressure. You wonder about the validity of prolonged CRT as a marker of poor organ blood flow in preterm newborns.

Clinical question

In newborn infants (patient) is CRT (test) an accurate marker of organ blood flow (outcome)?

Search strategy

Secondary sources

Review of Turning Research into Practice database and BestBETS revealed an evidence-based synopsis assessing the validity of CRT in paediatric intensive care, but no similar review for neonatal practice.

Primary sources

PubMed search with search terms (capillary refill time or capillary refilling time) and neonate revealed 31 papers.

On further review of abstracts 23 were excluded (2 review articles, 2 case reports, 8 not assessing CRT, 9 assessing CRT in non-neonatal …

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