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Discordance Between Capillary Refill Time and Oxygen Extraction Ratio in Septic Shock

Recruitingn/aAges 18 Years - anyAllIstanbul University - Cerrahpasa
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In plain words

What the trial is, and whether it could suit you

In septic shock, restoring large-vessel (macrocirculatory) perfusion-reflected by a normal capillary refill time (CRT)-does not always mean that oxygen use at the tissue level has recovered. This mismatch, sometimes called loss of hemodynamic coherence, may be detectable by comparing CRT with the oxygen extraction ratio (O₂ER), a marker of how much oxygen the tissues are extracting from the blood. Patients whose CRT has normalized but whose O₂ER remains abnormal-either too high (suggesting oxygen delivery that is insufficient for demand) or too low (suggesting microcirculatory shunting)-are considered to have a "discordant" perfusion phenotype. This prospective, single-center, observational cohort study aims to determine how often this CRT-O₂ER discordance occurs at the 6th hour of resuscitation in adult patients with septic shock, and whether it is associated with 28-day mortality. App

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📋 Eligibility rules (as published)
Inclusion Criteria: * Age ≥ 18 years * Diagnosis of septic shock according to the Surviving Sepsis Campaign (SSC) 2026 guideline * Presence of both a central venous catheter and an arterial line Exclusion Criteria: * Active bleeding * Ongoing extracorporeal membrane oxygenation (ECMO) * Raynaud phenomenon or significant peripheral vascular disease that makes capillary refill time measurement unreliable (e.g., critical ischemia, amputation, digital ulcer/necrosis, or inability to measure on the right index finger) * Death within the first 6 hours * Inability to obtain hour-6 CRT or blood gas (phenotyping not possible)
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What it tests

  • Capillary refill time (CRT)
  • Oxygen extraction ratio (O₂ER) assessment
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Where

1 site
Basaksehir Cam and Sakura City Hospital
Istanbul, Turkey (Türkiye)
🤝 Taking part is your choice, and you can leave at any time. Only the trial team can confirm you are eligible — always decide together with your own doctor.
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