{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T06:57:11Z","timestamp":1789541831194,"version":"build-2803163510"},"reference-count":56,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2022,11,1]],"date-time":"2022-11-01T00:00:00Z","timestamp":1667260800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["www.atsjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,11,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Identification of cardiogenic shock severity is a critical step to adapt the management level upon admission. Peripheral tissue perfusion signs, simple and reliable markers of tissue hypoperfusion have never been extensively assessed during cardiogenic shock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To assess the correlation of capillary refill time values with 90-day mortality in cardiogenic shock patients or the need for venoarterial extracorporeal membrane oxygenation (VA-ECMO) support. Also to assess the correlation between capillary refill time and hemodynamic parameters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive patients with cardiogenic shock admitted to the intensive care unit of two tertiary teaching hospitals were included in a prospective observational study. Macro-hemodynamic parameters (such as heart rate, blood pressure, left ventricular ejection fraction, and cardiac index) and peripheral tissue perfusion signs, such as capillary refill time on the index fingertip, mottling, and Pv-aCO2 (the difference between partial pressure of CO2 between venous and arterial blood) were recorded at inclusion (0 hour), 6 hours, 12 hours, 24 hours, and 48 hours. The composite primary endpoint was the association between 90-day mortality or the need for VA-ECMO support.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>A total of 61 patients were included; at inclusion, simplified acute physiology score II was 64 (52\u201377) points. The primary endpoint was met by 42% of patients. Capillary refill time values were significantly higher at all time points in nonsurvivors or patients needing VA-ECMO support. In univariate analysis, capillary refill time\u2009&amp;gt;\u20093 seconds at inclusion was associated with 90-day all-cause mortality or VA-ECMO support (hazard ratio, 12.38; 95% confidence interval, 2.91\u201352.71). Capillary refill time at inclusion was poorly associated with macrocirculatory parameters but significantly correlated with microcirculatory parameters. Further, capillary refill time added incremental value to Cardshock score, with an AUC combination at 0.93.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with cardiogenic shock admitted to the ICU, our preliminary data suggest that a prolonged capillary refill time\u2009&amp;gt;3\u2009seconds was associated with an early prediction of 90-day mortality or the need for VA-ECMO support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.202204-0687oc","type":"journal-article","created":{"date-parts":[[2022,7,18]],"date-time":"2022-07-18T14:55:31Z","timestamp":1658156131000},"page":"1230-1238","update-policy":"https:\/\/doi.org\/10.1164\/crossmarkpolicies","source":"Crossref","is-referenced-by-count":58,"title":["Performance of Early Capillary Refill Time Measurement on Outcomes in Cardiogenic Shock: An Observational, Prospective Multicentric Study"],"prefix":"10.1093","volume":"206","author":[{"given":"Hamid","family":"Merdji","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Strasbourg, Facult\u00e9 de M\u00e9decine; H\u00f4pitaux universitaires de Strasbourg, Nouvel H\u00f4pital Civil, Service de M\u00e9decine Intensive-R\u00e9animation, Strasbourg, France"},{"name":"INSERM (French National Institute of Health and Medical Research), Unit\u00e9 Mixte de Recherche (UMR) 1260, Regenerative Nanomedicine, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anais","family":"Curtiaud","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Strasbourg, Facult\u00e9 de M\u00e9decine; H\u00f4pitaux universitaires de Strasbourg, Nouvel H\u00f4pital Civil, Service de M\u00e9decine Intensive-R\u00e9animation, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Aheto","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Strasbourg, Facult\u00e9 de M\u00e9decine; H\u00f4pitaux universitaires de Strasbourg, Nouvel H\u00f4pital Civil, Service de M\u00e9decine Intensive-R\u00e9animation, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Studer","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Strasbourg, Facult\u00e9 de M\u00e9decine; H\u00f4pitaux universitaires de Strasbourg, Nouvel H\u00f4pital Civil, Service de M\u00e9decine Intensive-R\u00e9animation, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veli-Pekka","family":"Harjola","sequence":"additional","affiliation":[{"name":"Emergency Medicine, University of Helsinki, Helsinki, Finland"},{"name":"Department of Emergency Medicine and Services, Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Monnier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Strasbourg, Facult\u00e9 de M\u00e9decine; H\u00f4pitaux universitaires de Strasbourg, Nouvel H\u00f4pital Civil, Service de M\u00e9decine Intensive-R\u00e9animation, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Duarte","sequence":"additional","affiliation":[{"name":"Centre d'Investigations Cliniques Plurith\u00e9matique, INSERM 1433; Medical Intensive Care Unit Brabois, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Girerd","sequence":"additional","affiliation":[{"name":"Centre d'Investigations Cliniques Plurith\u00e9matique, INSERM 1433; Medical Intensive Care Unit Brabois, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Kibler","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Strasbourg University Hospital, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafid","family":"Ait-Oufella","sequence":"additional","affiliation":[{"name":"Intensive Care Unit, Saint-Antoine Hospital, Assistance Publique-H\u00f4pitaux de Paris, Paris, France"},{"name":"INSERM U970, Cardiovascular Research Center, Universit\u00e9 de Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Helms","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Strasbourg, Facult\u00e9 de M\u00e9decine; H\u00f4pitaux universitaires de Strasbourg, Nouvel H\u00f4pital Civil, Service de M\u00e9decine Intensive-R\u00e9animation, Strasbourg, France"},{"name":"INSERM (French National Institute of Health and Medical Research), Unit\u00e9 Mixte de Recherche (UMR) 1260, Regenerative Nanomedicine, Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Mebazaa","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology, Burn and Critical Care, Saint Louis-Lariboisi\u00e8re University Hospitals, Assistance Publique-H\u00f4pitaux de Paris, Paris, France"},{"name":"INSERM UMR-S 942, Cardiovascular Markers in Stress Conditions, F\u00e9d\u00e9ration Hospitalo-Universitaire Promice, University of Paris, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Levy","sequence":"additional","affiliation":[{"name":"INSERM U1116, Universit\u00e9 de Lorraine, Institut Lorrain du Coeur et des Vaisseaux, Centre Hospitalier R\u00e9gional Universitaire de Nancy, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Kimmoun","sequence":"additional","affiliation":[{"name":"INSERM 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