ArticleCritical care (London, England)2016
Real-time point of care microcirculatory assessment of shock: design, rationale and application of the point of care microcirculation (POEM) tool.
Article in Critical care (London, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
12 citing papers in PubMed.
- Sublingual microcirculatory assessment on admission independently predicts the outcome of old intensive care patients suffering from shock.Scientific reports · 2024Trial
- Direct assessment of microcirculation in shock: a randomized-controlled multicenter study.Intensive care medicine · 2023Trial
- Capillary leak and endothelial permeability in critically ill patients: a current overview.Intensive care medicine experimental · 2023Review
- On Admission, Microcirculation Abnormality is an Independent Predictor of Sepsis and Sepsis-related Mortality: A Hospital-based Study.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2022Article
- Role of albumin in the preservation of endothelial glycocalyx integrity and the microcirculation: a review.Annals of intensive care · 2020Review
- Point-of-care microcirculation evaluated with sidestream dark field technology: agreement and comparison between sublingual and sublabial mucosa.American journal of translational research · 2020Article
- Perioperative Quality Initiative (POQI) consensus statement on fundamental concepts in perioperative fluid management: fluid responsiveness and venous capacitance.Perioperative medicine (London, England) · 2020Article
- Assessing the Microcirculation With Handheld Vital Microscopy in Critically Ill Neonates and Children: Evolution of the Technique and Its Potential for Critical Care.Frontiers in pediatrics · 2019Review
- Could resuscitation be based on microcirculation data? No.Intensive care medicine · 2018Article
- Second consensus on the assessment of sublingual microcirculation in critically ill patients: results from a task force of the European Society of Intensive Care Medicine.Intensive care medicine · 2018Article
- Perfusion indices revisited.Journal of intensive care · 2017Review
- Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite over a decade of research and technological advances, sublingual microcirculatory monitoring has not yet reached clinical utility. Offline analysis is time consuming and occurs away from the patient. A system to assess the microcirculation at the point of care is desirable. We present a novel 5-point grading system (the point of care microcirculation (POEM) scoring system) that can be used at the point of care during non-invasive sublingual microcirculatory monitoring.
methodsThe POEM score is an ordinal scale from 1 (worst) to 5 (best), based on a composite assessment of flow and heterogeneity of four individual sublingual video-microscopy clips. Thirty-two healthcare professionals were trained in how to assign POEM scores. Following training they assigned scores to five test sequences (each consisting of four video clips). They were blinded to clinical status. Inter-user consistency and agreement were assessed using intra-class correlation coefficient (ICC) analysis. In addition, blinded expert scores for 68 video clips were compared to offline computer analysis using traditional microcirculatory parameters including total vessel density (TVD), perfused vessel density (PVD), proportion of perfused vessels (PPV), microcirculatory flow index (MFI) and microcirculatory heterogeneity index (MHI). The time taken to assign each was recorded.
resultsParticipants showed good inter-rater consistency (ICC 0.83, 95 % CI 0.626, 0.976) and agreement (ICC 0.815, 95 % CI 0.602, 0.974) for assigned POEM scores. Expert scoring of videos correlated with offline values for PVD (R
conclusionWe present for the first time a novel 5-point ordinal scale of microcirculatory flow and heterogeneity that can be used at the point of care. It has minimal inter-user variability amongst healthcare professionals after just 1 hour of training. POEM scores take a short time to assign, and correspond well to traditional offline computer-analyzed parameters.
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