Evidence map›Paper›PMID 39838473›Full record

Observational studyCritical care (London, England)2025

The association of capillary refill time and return of spontaneous circulation during out-of-hospital cardiac arrest: an observational study.

Matthias Mueller, Michael Holzer, Heidrun Losert, Daniel Grassmann, Florian Ettl, Mathias Gatterbauer, Ingrid Magnet, Alexander Nuernberger, Calvin Lukas Kienbacher, Georg Gelbenegger and 3 more

Registry-linked trialAbstract readObservational Study
In one paragraph

Observational study in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04791995 (REsuscitation and CAPillary rePerfusion - A Cohort Study With Prospective Inclusion), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04791995 completednot on this map

REsuscitation and CAPillary rePerfusion - A Cohort Study With Prospective Inclusion

TypeobservationalSponsorMedical University of ViennaRan2021 to 2022Enrolled50ConditionsCardiac Arrest, Cardiac Arrest, Out-Of-Hospital, Cardiopulmonary Arrest, Cardiopulmonary Arrest With Successful Resuscitation
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Matthias MuellerDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090, Vienna, Austria.
Michael HolzerDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090, Vienna, Austria. Michael.holzer@meduniwien.ac.at.
Heidrun LosertDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090, Vienna, Austria.
Daniel GrassmannEmergency Medical Service Vienna, Vienna, Austria.
Florian EttlDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090, Vienna, Austria.
Mathias GatterbauerEmergency Medical Service Vienna, Vienna, Austria.
Ingrid MagnetDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090, Vienna, Austria.
Alexander NuernbergerDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090, Vienna, Austria.
Calvin Lukas KienbacherDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090, Vienna, Austria.
Georg GelbeneggerDepartment of Clinical Pharmacology, Medical University of Vienna, Vienna, Austria.
Michael GirsaEmergency Medical Service Vienna, Vienna, Austria.
Harald HerknerDepartment of Emergency Medicine, Medical University of Vienna, Waehringer Guertel 18-20/6D, 1090, Vienna, Austria.
Mario KrammelEmergency Medical Service Vienna, Vienna, Austria.

Funding

Medical Scientific Fund of the Mayor of the City of Vienna 21171
6 · The paper itself

Abstract

introductionMicrocirculatory alterations are predictive of poor outcomes in patients with shock and after cardiac arrest in animal models. However, microcirculatory alterations during human cardiac arrest have not yet been studied.

methodsWe prospectively included adult patients receiving resuscitation after witnessed out-of-hospital cardiac arrest. Exclusion criteria were hypovolemia, hypo- or hyperthermia (< 34.0 °C, > 37.5 °C), peripheral arterial disease, Raynaud's disease, and logistical issues (e.g., shortage of space). Capillary refill time was measured on the finger (CRT-F) and the earlobe (CRT-E) every other minute until return of spontaneous circulation (any ROSC) or termination of resuscitation. The primary endpoint was any ROSC, secondary endpoints were 30-day-mortality and good neurological outcome (defined as cerebral performance category 1-2). Based on the data structure, CRT-F and CRT-E values were grouped post-hoc into quartiles and tertiles. A cluster-robust standard error logistic regression was performed for the primary outcome. Trend analyses were made for each individual.

resultsAfter screening of 141 patients, 50 were included in the analysis (median age 75 years, 28% female, any ROSC 32%). The median CRT-F was > 10 [7-> 10] seconds; the median CRT-E was 3 [3-4] seconds. The any ROSC rate for patients in CRT-F quartile 1 (3-5 s) was 71.4%, 31.7% in quartile 2 (6-8 s), 23.1% in quartile 3 (9-10 s), and 10% in quartile 4 (> 10 s). The odds ratio of 0.39 (95% CI 0.20-0.73, p = 0.004) indicated, that with an increase of CRT-F by a quartile, the chance of achieving any ROSC decreased by 61%. Patients with a decreasing CRT-F achieved any ROSC in 70%, whereas patients with constant or increasing CRT-F had any ROSC in only 21% (p = 0.008). In contrast, CRT-E showed no association with any ROSC (T1 [1-2 s.]: 16.7%, T2 [3 s.]: 27.5%, T3 [4-> 10 s.]: 22.4%, OR by tertiles: 1.18, 95% CI 0.58-2.44, p = 0.646).

conclusionDuring out-of-hospital cardiac arrest, shorter CRT-F, but not CRT-E, is associated with a higher chance of any ROSC.

trial registrationThis trial was pre-registered on clinicaltrials.gov with the number: NCT04791995 on March 2nd, 2021.

Indexed as

CapillariesMicrocirculationOut-of-Hospital Cardiac ArrestReturn of Spontaneous CirculationAgedCardiopulmonary ResuscitationFemaleHumansMaleMiddle AgedProspective StudiesTime FactorsCapillary refill timeCardiac arrestMicrocirculationOut-of-hospital cardiac arrestResuscitation outcomesReturn of spontaneous circulation

Identifiers

PMID39838473
PMCPMC11748279

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.