Prolonged capillary refill

Abnormally increased capillary refill time (typically >2–3 seconds) after blanching of the skin or nail bed, indicating delayed restoration of peripheral blood flow and impaired tissue perfusion.

Causes

• Hypovolemia

  • Dehydration

  • Hemorrhage

  • Severe fluid loss from vomiting, diarrhea, or burns

  • Reduced intravascular volume

• Shock

  • Septic shock

  • Hypovolemic shock

  • Cardiogenic shock

  • Obstructive shock

• Heart failure

• Peripheral vascular causes

  • Peripheral artery disease

  • Acute limb ischemia

  • Peripheral vasoconstriction (Raynaud, hypothermia, vasopressors)