The effect of general anesthesia on capillary refill time in patients with congestive heart failure compared to the control group

Abstract

Background: Capillary refill time (CRT) largely used as a quick way to assess the cardiovascular system and the status of peripheral blood flow and perfusion in patients. On the other hand, cardiac heart failure is a complex clinical syndrome happens due to improper ventricular function and causes ventricular hypertrophy and dilatation tends to decreasing in cardiac functioning and in capillary refill time. This field sometimes has contradiction and this study aimed to determine the effect of general anesthesia on capillary refill time in patients with congestive heart failure compared to the control group. Methods: In a prospective cohort study, 50 patients with congestive heart failure and 50 non-affected patients with cardiovascular disease undergoing elective surgery, were selected and both capillary refill time and hemodynamic parameters before induction of anesthesia and 30 minutes after it, were measured and compared. Findings: The mean capillary refill time before induction of anesthesia was 94.0 ± 21.0 and 76.0 ± 18.0 minutes in patients and controls group and the difference was statistically significant. The mean capillary refill time 30 minutes after induction of anesthesia was significantly higher in patients (90.0 ± 18.0 minutes) compared to the controls (81.0 ± 17.0 minutes) (P < 0.001). All hemodynamic parameters were significantly different between the two groups before induction of anesthesia; but in 30 minutes after surgery, systolic blood pressure and heart rate were not significantly different but diastolic blood pressure was significantly different between the two groups. Conclusion: Patients with congestive heart failure in terms of hemodynamic parameters are different from those without it. It is necessary that during the operation, anesthesiologists should pay special attention to hemodynamic status of these patients. While such patients have longer capillary filling time compared to normal individuals, we can use this parameter as an indicator of the likelihood of heart failure in care and examination before the surgery. © 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved.