ArticleIntensive care medicine experimental2017
Assessment of endothelial cell function and physiological microcirculatory reserve by video microscopy using a topical acetylcholine and nitroglycerin challenge.
Article in Intensive care medicine experimental, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03651635 (To Assess and Validate the Use of MR-proADM and the CT-proET-1/MR-proADM Ratio as Prognostic Markers During the First 7 Days of ICU Treat-ment), which is not on this map. Cited by 16 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
To Assess and Validate the Use of MR-proADM and the CT-proET-1/MR-proADM Ratio as Prognostic Markers During the First 7 Days of ICU Treat-ment
Who cites it
16 citing papers in PubMed, 33 citations in OpenAlex.
- Exploring air insole pressure and walking durations effects on microcirculation in healthy individuals to optimize diabetic foot ulcers prevention.Scientific reports · 2025Trial
- Improved Detection of Capillaries in High-Resolution Handheld Vital Microscopy by Use of the MicroTools Advanced Computer Vision Algorithm.Microcirculation (New York, N.Y. : 1994) · 2026Article
- Clinical value of sublingual microcirculatory dysfunction for screening for primary aldosteronism in hypertensive patients.Frontiers in endocrinology · 2025Article
- Nitroglycerin challenge identifies microcirculatory target for improved resuscitation in patients with circulatory shock.Intensive care medicine experimental · 2024Article
- Noninvasive assessment of human microvascular function in health and disease using incident dark-field microscopy.American journal of physiology. Heart and circulatory physiology · 2024Article
- Local carbachol application induces oral microvascular recruitment and improves gastric tissue oxygenation during hemorrhagic shock in dogs.Frontiers in immunology · 2024Article
- Novelties in the evaluation of microcirculation in septic shock.Journal of intensive medicine · 2023Review
- Microcirculatory alterations in critically ill COVID-19 patients analyzed using artificial intelligence.Critical care (London, England) · 2022Article
- Topical nitroglycerin to detect reversible microcirculatory dysfunction in patients with circulatory shock after cardiovascular surgery: an observational study.Scientific reports · 2022Observational
- Evaluation of automated microvascular flow analysis software AVA 4: a validation study.Intensive care medicine experimental · 2021Article
- Assessment of sublingual microcirculation in critically ill patients: consensus and debate.Annals of translational medicine · 2020Review
- Physiology and technology for the ICU in vivo.Critical care (London, England) · 2019Review
- Recruitment of non-perfused sublingual capillaries increases microcirculatory oxygen extraction capacity throughout ascent to 7126 m.The Journal of physiology · 2019Article
- MicroTools enables automated quantification of capillary density and red blood cell velocity in handheld vital microscopy.Communications biology · 2019Article
- 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
- Assessment of endothelial cell function and physiological microcirculatory reserve by video microscopy using a topical acetylcholine and nitroglycerin challenge.Intensive care medicine experimental · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAssessment of the microcirculation is a promising target for the hemodynamic management of critically ill patients. However, just as the sole reliance on macrocirculatory parameters, single static parameters of the microcirculation may not represent a sufficient guide. Our hypothesis was that by serial topical application of acetylcholine (ACH) and nitroglycerin (NG), the sublingual microcirculation can be challenged to determine its endothelial cell-dependent and smooth muscle-dependent physiological reserve capacity.
methodsIn 41 healthy subjects, sublingual capillary microscopy was performed before and after topical application of ACH and NG. Total vessel density (TVD) was assessed in parallel using manual computer-assisted image analysis as well as a fully automated analysis pathway utilizing a newly developed computer algorithm. Flow velocity was assessed using space-time diagrams of the venules as well as the algorithm-based calculation of an average perfused speed indicator (APSI).
resultsNo change in all measured parameters was detected after sublingual topical application of ACH. Sublingual topical application of NG however led to an increase in TVD, space-time diagram-derived venular flow velocity and APSI. No difference was detected in heart rate, blood pressure, and cardiac output as measured by echocardiography, as well as in plasma nitric oxide metabolite content before and after the topical application of ACH and NG.
conclusionsIn healthy subjects, the sublingual microcirculatory physiological reserve can be assessed non-invasively by topical application of nitroglycerin without affecting systemic circulation.
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