Several studies have validated capillary refill time (CRT) as a marker of tissue hypoperfusion, and recent guidelines recommend CRT monitoring during septic shock resuscitation. Therefore, it is relevant to further explore its kinetics of response to short-term hemodynamic interventions with fluids or vasopressors.

Our findings support that fluid boluses may improve CRT in fluid-responsive septic shock patients with persistent hypoperfusion, while producing neutral effects in a few.

Conversely, raising NE doses to target a higher MAP in previously hypertensive patients elicits a more heterogeneous response, improving CRT in the majority, but deteriorating skin perfusion in some patients with concomitant vasopressin infusion, a fact that deserves further research.

Assessing CRT response to acute hemodynamic interventions, such as described in this study, may potentially aid in the effort to personalize septic shock resuscitation.

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