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What is Capillary fill fast in which of the following type of shock: March 2013 (d, e, g) and explain in detail?
Ans. A i.e. Septic shock Harrison's Medicine, 16th ed., p-1604 states that capillary refill time is prolonged in hypovolemic shock Capillary refill It is the rate at which blood refills empty capillaries. It can be measured by holding a hand higher than hea-level (prevents venous reflux), pressing the soft pad of a finger or toe until it turns white, and taking note of the time needed for the color to return once pressure is released. Normal refill time is less than 2 seconds. In newborn infants, capillary refill can be measured by pressing on the sternum for five seconds with a finger or thumb, and noting the time needed for the colour to return once the pressure is released. The upper normal limit for capillary refill in newborns is 3 seconds. The capillary refill time (C) is a common indication of dehydration and decreased peripheral perfusion. It is very useful as suppoing evidence for a positive sign of poor perfusion to the extremities. The C test is often referred to as the Nail blanch test. Septic shock In early stages of septic shock (the hyperdynamic phase), patients may show dark red mucous membranes with a sho capillary refill time (C In more advanced stages mucous membranes may seem grey and dry and there will be an increased C and weak pulses.