El tiempo de llene capilar prolongado es predictor de una saturación venosa central de oxígeno disminuida

Abstract

A prolonged capillary refill is predictor of low central venous oxygen saturation introduction: Educational programs in pediatric life support endorse a capillary refill time > 2 s as an indicator of shock. In the emergency room, a barrier to the implementation of an early goal directed therapy, aiming at central venous oxygen saturation (ScvO 2) ≥ 70% is the insertion of central venous catheter (CVC). Objective: To establish the predictive value of capillary refill time > 2 s to detect ScvO 2 < 70% in children admitted to Intensive Care Units. patients and method: Prospective study. We included 48 children admitted in the first 24 hours in ICU with superior vena cava CVC. Simultaneously, we measured ScvO 2 and capillary refill time in the heel of upper extremity or toe. results: There were 75 paired measurements ScvO 2 (75,9 ± 8,4%) and capillary refill capillary (1,9 ± 1,0 s). We found an inverse correlation between capillary refill time and ScvO 2 (r-0,58). The ROC curve analysis revealed an excellent ability for the capillary fill time > 2 s to predict ScvO 2 < 70% (AUC 0,94) (95% CI 0,87-0,98). Conclusions: A prolonged capillary refill time > 2 s, is a predictor of ScvO 2 < 70% in children admitted to ICU, which supports the current recommendations. This finding may be relevant in emergency units where the use of CVC is limited and ScvO 2 is not available. (