ArticleResuscitation2013
Sublingual microcirculation is impaired in post-cardiac arrest patients.
Article in Resuscitation, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 45 citations in OpenAlex.
- Resuscitation-associated endotheliopathy (RAsE): a conceptual framework based on a systematic review and meta-analysis.Systematic reviews · 2023Pooled it
- Corticosteroid therapy in refractory shock following cardiac arrest: a randomized, double-blind, placebo-controlled, trial.Critical care (London, England) · 2016Trial
- [Pathophysiology of postcardiac arrest syndrome].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- Management of post-resuscitation vasoplegic shock: targets, strategies and outcomes.Critical care (London, England) · 2025Review
- Cutaneous microcirculatory disturbances are reversible in the early post-resuscitation period after asphyxial cardiac arrest.Cardiovascular diagnosis and therapy · 2025Article
- Observational Study of Sublingual Microcirculation in Patients With Chronic Cardiovascular Disease.Microcirculation (New York, N.Y. : 1994) · 2025Observational
- Physiology-Guided Resuscitation: Monitoring and Augmenting Perfusion during Cardiopulmonary Arrest.Journal of clinical medicine · 2024Review
- Anisodamine hydrobromide ameliorates cardiac damage after resuscitation.Experimental and therapeutic medicine · 2022Article
- Effects of Methylprednisolone on Myocardial Function and Microcirculation in Post-resuscitation: A Rat Model.Frontiers in cardiovascular medicine · 2022Article
- Characteristics of circulatory failure after out-of-hospital cardiac arrest: a prospective cohort study.Open heart · 2022Observational
- Targeted Temperature Management Suppresses Hypoxia-Inducible Factor-1α and Vascular Endothelial Growth Factor Expression in a Pig Model of Cardiac Arrest.Neurocritical care · 2021Article
- Efficacy of CytoSorb in a Pediatric Case of Severe Multisystem Infammatory Syndrome (MIS-C): A Clinical Case Report.Frontiers in pediatrics · 2021Article
- Leukocyte-Endothelium Interaction in the Sublingual Microcirculation of Coronary Artery Bypass Grafting Patients.Journal of vascular research · 2020Observational
- Three-Dimensional Shapes and Cell Deformability of Rat Red Blood Cells during and after Asphyxial Cardiac Arrest.Emergency medicine international · 2019Article
- The Sublingual Microcirculation Throughout Neonatal and Pediatric Extracorporeal Membrane Oxygenation Treatment: Is It Altered by Systemic Extracorporeal Support?Frontiers in pediatrics · 2019Article
- Microcirculation in cardiogenic shock supported with extracorporeal membrane oxygenation: the need for a homogeneous population and strict evolution assessment.Critical care (London, England) · 2018Article
- Effects of Mild Hypothermia on Cerebral Large and Small Microvessels Blood Flow in a Porcine Model of Cardiac Arrest.Neurocritical care · 2017Article
- Evaluation of sublingual microcirculation in a paediatric intensive care unit: prospective observational study about its feasibility and utility.BMC pediatrics · 2017Observational
- Microcirculatory blood flow during cardiac arrest and cardiopulmonary resuscitation does not correlate with global hemodynamics: an experimental study.Journal of translational medicine · 2016Article
- Inflammasome and toll-like receptor signaling in human monocytes after successful cardiopulmonary resuscitation.Critical care (London, England) · 2016Article
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Authors and funding
8 authors at 2 institutions in 2 countries.
Funding
Abstract
aimWe hypothesized that microcirculatory dysfunction, similar to that seen in sepsis, occurs in post-cardiac arrest patients and that better microcirculatory flow will be associated with improved outcome. We also assessed the association between microcirculatory dysfunction and inflammatory markers in the post-cardiac arrest state.
methodsWe prospectively evaluated the sublingual microcirculation in post-cardiac arrest patients, severe sepsis/septic shock patients, and healthy control patients using Sidestream Darkfield microscopy. Microcirculatory flow was assessed using the microcirculation flow index (MFI) at 6 and 24h in the cardiac arrest patients, and within 6h of emergency department admission in the sepsis and control patients.
resultsWe evaluated 30 post-cardiac arrest patients, 16 severe sepsis/septic shock patients, and 9 healthy control patients. Sublingual microcirculatory blood flow was significantly impaired in post-cardiac arrest patients at 6h (MFI 2.6 [IQR: 2-2.9]) and 24h (2.7 [IQR: 2.3-2.9]) compared to controls (3.0 [IQR: 2.9-3.0]; p<0.01 and 0.02, respectively). After adjustment for initial APACHE II score, post-cardiac arrest patients had significantly lower MFI at 6-h compared to sepsis patients (p<0.03). In the post-cardiac arrest group, patients with good neurologic outcome had better microcirculatory blood flow as compared to patients with poor neurologic outcome (2.9 [IQR: 2.4-3.0] vs. 2.6 [IQR: 1.9-2.8]; p<0.03). There was a trend toward higher median MFI at 24h in survivors vs. non-survivors (2.8 [IQR: 2.4-3.0] vs. 2.6 [IQR: 2.1-2.8] respectively; p<0.09). We found a negative correlation between MFI-6 and vascular endothelial growth factor (VEGF) (r=-0.49, p=0.038). However, after Bonferroni adjustment for multiple comparisons, this correlation was statistically non-significant.
conclusionMicrocirculatory dysfunction occurs early in post-cardiac arrest patients. Better microcirculatory function at 24h may be associated with good neurologic outcome.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.