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<p>Capillary Refill Time (CRT) is a valuable metric to assess cutaneous perfusion. Its prognostic value in patients with acute circulatory failure has been reported as improved when the measurement is standardized. The DiCART™ device is a fully automated CRT measurement tool requiring validation. We conducted a comparative interventional single-center study including 25 patients with acute circulatory failure, to evaluate the agreement between CRT measured by an automated measurement device (CRT<sub>DiCART</sub>) and CRT measured clinically (CRT<sub>CLIN</sub>). CRT was measured on the fingertip, chest, and knee. Three measurements were performed at each location to obtain an average for each site. The measurements were conducted both clinically and using the DiCART™ device by two different operators, each blinded to the results. Agreement was determined using intraclass correlation coefficient (ICC) and Bland and Altman analysis. The ICC between CRT<sub>CLIN</sub> and CRT<sub>DiCART</sub> was 0.46 (95% Confidence Interval (CI) 0.32, 0.59) across all measurement sites; the mean bias was 0.23s (95% CI -0.17, 0.64), with upper Limit of Agreement (LoA) 2.77s (95% CI 2.44, 3.20) and lower LoA − 2.30s (-2.73, -1.97). Intra observer ICC was 0.85 (95% CI 0.74, 0.91) for CRT<sub>CLIN</sub> and 0.43 (95% CI 0.15, 0.64) for CRT<sub>DICART</sub>. Inter observer ICC was 0.86 (95% CI 0.76, 0.92) for CRT<sub>CLIN</sub> and was 0.41 (95% CI 0.14, 0,63) for CRT<sub>DICART</sub>. The DiCART™ device showed poor agreement with clinical CRT in patients with acute circulatory failure, which does not support its use in routine practice.</p>

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DiCARTTM device to measure capillary refill time: a validation study in patients with acute circulatory failure

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年2月26日

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  • Alexandre Descamps,
  • Matthias Jacquet-Lagrèze,
  • Thomas Aussal,
  • Jean-Luc Fellahi,
  • Martin Ruste

摘要

Capillary Refill Time (CRT) is a valuable metric to assess cutaneous perfusion. Its prognostic value in patients with acute circulatory failure has been reported as improved when the measurement is standardized. The DiCART™ device is a fully automated CRT measurement tool requiring validation. We conducted a comparative interventional single-center study including 25 patients with acute circulatory failure, to evaluate the agreement between CRT measured by an automated measurement device (CRTDiCART) and CRT measured clinically (CRTCLIN). CRT was measured on the fingertip, chest, and knee. Three measurements were performed at each location to obtain an average for each site. The measurements were conducted both clinically and using the DiCART™ device by two different operators, each blinded to the results. Agreement was determined using intraclass correlation coefficient (ICC) and Bland and Altman analysis. The ICC between CRTCLIN and CRTDiCART was 0.46 (95% Confidence Interval (CI) 0.32, 0.59) across all measurement sites; the mean bias was 0.23s (95% CI -0.17, 0.64), with upper Limit of Agreement (LoA) 2.77s (95% CI 2.44, 3.20) and lower LoA − 2.30s (-2.73, -1.97). Intra observer ICC was 0.85 (95% CI 0.74, 0.91) for CRTCLIN and 0.43 (95% CI 0.15, 0.64) for CRTDICART. Inter observer ICC was 0.86 (95% CI 0.76, 0.92) for CRTCLIN and was 0.41 (95% CI 0.14, 0,63) for CRTDICART. The DiCART™ device showed poor agreement with clinical CRT in patients with acute circulatory failure, which does not support its use in routine practice.