Evaluation of sublingual microcirculatory blood flow in the critically ill - PubMed (original) (raw)
Evaluation of sublingual microcirculatory blood flow in the critically ill
M Sallisalmi et al. Acta Anaesthesiol Scand. 2012 Mar.
Abstract
Background: The microcirculation regulates the supply of oxygen and nutrients to tissues. The sublingual region is frequently used as a window to microcirculation in critically ill patients. Numerous studies have reported impaired sublingual microcirculatory flow. We hypothesized that the quality of sidestream dark field imaging (SDF) recordings could be systematically analyzed to justify the monitoring of sublingual microcirculation in interventional studies or in clinical practice.
Methods: The sublingual microcirculation in critically ill patients with septic shock, open heart surgery, or alcoholic pancreatitis, and healthy subjects was recorded with a hand held SDF device by one trained investigator in observational setting. A total of 82 video recording sessions were performed and 240 video clips eligible for quality assessment were identified. Quality assessment was performed offline by two investigators independently and blinded for the origin of the video file.
Results: Of the 240 clips, pressure artifact was detected in 86 (36%), major blood in 5 (2.1%), major saliva in 21 (8.8%) and extreme brightness causing loss of visible capillaries in 16 (6.7%) clips. The dominating vessel architecture was multiple size vessels in 228 (95%) and repeating capillary loop motif in 12 (5.0%). The mean (± SD) relative size reduction during stabilization was -6.9% (± 4.7%). Excellent technical quality was detected in 74 of 240 (30.8%) recordings.
Conclusions: Our findings highlight the need of a comprehensive training period and reporting of data quality before findings with SDF imaging can be accepted as surrogate end points in interventional studies or as guidance in clinical practice.
© 2011 The Authors Acta Anaesthesiologica Scandinavica © 2011 The Acta Anaesthesiologica Scandinavica Foundation.
Similar articles
- Early microcirculatory perfusion derangements in patients with severe sepsis and septic shock: relationship to hemodynamics, oxygen transport, and survival.
Trzeciak S, Dellinger RP, Parrillo JE, Guglielmi M, Bajaj J, Abate NL, Arnold RC, Colilla S, Zanotti S, Hollenberg SM; Microcirculatory Alterations in Resuscitation and Shock Investigators. Trzeciak S, et al. Ann Emerg Med. 2007 Jan;49(1):88-98, 98.e1-2. doi: 10.1016/j.annemergmed.2006.08.021. Epub 2006 Nov 7. Ann Emerg Med. 2007. PMID: 17095120 - [Microcirculatory failure of sublingual perfusion in septic-shock patients. Examination by OPS imaging and PiCCO monitoring].
Wiessner R, Gierer P, Schaser K, Pertschy A, Vollmar B, Klar E. Wiessner R, et al. Zentralbl Chir. 2009 Jun;134(3):231-6. doi: 10.1055/s-0028-1098702. Epub 2009 Jun 17. Zentralbl Chir. 2009. PMID: 19536717 German. - Microcirculatory imaging in cardiac anesthesia: ketanserin reduces blood pressure but not perfused capillary density.
Elbers PW, Ozdemir A, van Iterson M, van Dongen EP, Ince C. Elbers PW, et al. J Cardiothorac Vasc Anesth. 2009 Feb;23(1):95-101. doi: 10.1053/j.jvca.2008.09.013. Epub 2008 Dec 5. J Cardiothorac Vasc Anesth. 2009. PMID: 19058975 - The heterogeneity of the microcirculation in critical illness.
Klijn E, Den Uil CA, Bakker J, Ince C. Klijn E, et al. Clin Chest Med. 2008 Dec;29(4):643-54, viii. doi: 10.1016/j.ccm.2008.06.008. Clin Chest Med. 2008. PMID: 18954699 Review. - Clinical review: Clinical imaging of the sublingual microcirculation in the critically ill--where do we stand?
Bezemer R, Bartels SA, Bakker J, Ince C. Bezemer R, et al. Crit Care. 2012 Jun 19;16(3):224. doi: 10.1186/cc11236. Crit Care. 2012. PMID: 22713365 Free PMC article. Review.
Cited by
- Impact of microcirculatory video quality on the evaluation of sublingual microcirculation in critically ill patients.
Damiani E, Ince C, Scorcella C, Domizi R, Carsetti A, Mininno N, Pierantozzi S, Adrario E, Romano R, Pelaia P, Donati A. Damiani E, et al. J Clin Monit Comput. 2017 Oct;31(5):981-988. doi: 10.1007/s10877-016-9924-7. Epub 2016 Aug 18. J Clin Monit Comput. 2017. PMID: 27539312 - Transcutaneous Microcirculatory Imaging in Preterm Neonates.
van Elteren H, Reiss IK, de Jonge RC. van Elteren H, et al. J Vis Exp. 2015 Dec 31;(106):e53562. doi: 10.3791/53562. J Vis Exp. 2015. PMID: 26779613 Free PMC article. - Skin perfusion pressure as an indicator of tissue perfusion in valvular heart surgery: Preliminary results from a prospective, observational study.
Song Y, Soh S, Shim JK, Park KU, Kwak YL. Song Y, et al. PLoS One. 2017 Sep 19;12(9):e0184555. doi: 10.1371/journal.pone.0184555. eCollection 2017. PLoS One. 2017. PMID: 28926643 Free PMC article. - Endothelial and Microcirculatory Function and Dysfunction in Sepsis.
Colbert JF, Schmidt EP. Colbert JF, et al. Clin Chest Med. 2016 Jun;37(2):263-75. doi: 10.1016/j.ccm.2016.01.009. Epub 2016 Mar 4. Clin Chest Med. 2016. PMID: 27229643 Free PMC article. Review. - Deeper penetration of erythrocytes into the endothelial glycocalyx is associated with impaired microvascular perfusion.
Lee DH, Dane MJ, van den Berg BM, Boels MG, van Teeffelen JW, de Mutsert R, den Heijer M, Rosendaal FR, van der Vlag J, van Zonneveld AJ, Vink H, Rabelink TJ; NEO study group. Lee DH, et al. PLoS One. 2014 May 9;9(5):e96477. doi: 10.1371/journal.pone.0096477. eCollection 2014. PLoS One. 2014. PMID: 24816787 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources