An automated quasi-continuous capillary refill timing device

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Blaxter, L.L. ; Morris, David E. ; Crowe, John A. ; Henry, C. ; Hill, Stephen J. ; Sharkey, Don ; Vyas, H. ; Hayes-Gill, Barrie R. (2015)

Capillary refill time (CRT) is a simple means of cardiovascular assessment which is widely used in clinical care. Currently, CRT is measured through manual assessment of the time taken for skin tone to return to normal colour following blanching of the skin surface. There is evidence to suggest that manually assessed CRT is subject to bias from ambient light conditions, a lack of standardisation of both blanching time and manually applied pressure, subjectiveness of return to normal colour, and variability in the manual assessment of time. We present a novel automated system for CRT measurement, incorporating three components: a non-invasive adhesive sensor incorporating a pneumatic actuator, a diffuse multi-wavelength reflectance measurement device, and a temperature sensor; a battery operated datalogger unit containing a self contained pneumatic supply; and PC based data analysis software for the extraction of refill time, patient skin surface temperature, and sensor signal quality.\ud Through standardisation of the test, it is hoped that some of the shortcomings of manual CRT can be overcome. In addition, an automated system will facilitate easier integration of CRT into electronic record keeping and clinical monitoring or scoring systems, as well as reducing demands on clinicians.\ud Summary analysis of volunteer (n = 30) automated CRT datasets are presented, from 15 healthy adults and 15 healthy children (aged from 5 to 15 years), as their arms were cooled from ambient temperature to 5°C. A more detailed analysis of two typical datasets is also presented, demonstrating that the response of automated CRT to cooling matches that of previously published studies.
  • References (22)
    22 references, page 1 of 3

    Cohen  A and Wadsworth  N 1972 A light emitting diode skin reflectance oximeter Med. Biol. Eng. 10 385-91

    Crismon J M and Fuhrman F A 1947 Studies on gangrene following cold injury: VI. Capillary blood flow after cold injury, the effects of rapid warming, and sympathetic block J. Clin. Investigation 26 468

    Duncan H, Hutchison J and Parshuram C S 2006 The pediatric early warning system score: a severity of illness score to predict urgent medical need in hospitalized children J. Crit. Care 21 271-8

    Fitzpatrick T B 1988 The validity and practicality of sun-reactive skin types I through VI Arch. Dermatol. 124 869-71

    Fleming S, Gill P, Jones C, Taylor J A, Van den Bruel A, Heneghan C and Thompson M 2014 Validity and reliability of measurement of capillary refill time in children: a systematic review Arch. Disease Child. 100 239-49

    Gorelick  M  H, Shaw  K  N and Baker  M  D 1993 Effect of ambient temperature on capillary refill in healthy children Pediatrics 92 699-702

    Grubb M, Carpenter J, Crowe J A, Teoh J, Marlow N, Ward C, Mann C, Sharkey D and Hayes-Gill B R 2014 Forehead reflectance photoplethysmography to monitor heart rate: preliminary results from neonatal patients Physiol. Meas. 35 881

    Guedel A E 1940 Cyclopropane anesthesia Anesthesiology 1 13-25

    Joseph D K, Huppert T J, Franceschini M A and Boas D A 2006 Diffuse optical tomography system to image brain activation with improved spatial resolution and validation with functional magnetic resonance imaging Appl. Opt. 45 8142-51

    Klupp N L and Keenan A M 2007 An evaluation of the reliability and validity of capillary refill time test Foot 17 15-20

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