ArticlePerioperative medicine (London, England)2018
Recruitment of sublingual microcirculation using handheld incident dark field imaging as a routine measurement tool during the postoperative de-escalation phase-a pilot study in post ICU cardiac surgery patients.
Article in Perioperative medicine (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- The effect of plasma versus crystalloids on intravascular volume, tissue perfusion and tissue oxygenation: a randomized controlled trial in a human endotoxemia model.Critical care (London, England) · 2026Trial
- Microcirculatory response and leukocyte activation in patients undergoing elective cardiac surgery with cardiopulmonary bypass.Journal of intensive medicine · 2026Article
- Microcirculation and Cerebrovascular Autoregulation in Patients With Mechanical Circulatory Support Devices.Journal of stroke · 2026Review
- Albumin 20% in surgical and critically ill patients; a comprehensive review.Critical care (London, England) · 2026Review
- Effects of fluids on sublingual microcirculation: a point of view review.Annals of intensive care · 2025Review
- Noninvasive Bedside Approaches for Assessing Microvascular Dysfunction.Journal of vascular research · 2025Review
- Changes in colloid oncotic pressure during cardiac surgery with different prime fluid strategies.Perfusion · 2024Article
- Nitroglycerin challenge identifies microcirculatory target for improved resuscitation in patients with circulatory shock.Intensive care medicine experimental · 2024Article
- Impairment of Mesenteric Perfusion as a Marker of Major Bleeding in Trauma Patients.Journal of clinical medicine · 2023Review
- Novelties in the evaluation of microcirculation in septic shock.Journal of intensive medicine · 2023Review
- Article
- Assessment of sublingual microcirculation in critically ill patients: consensus and debate.Annals of translational medicine · 2020Review
- Intravenous fluid therapy in the perioperative and critical care setting: Executive summary of the International Fluid Academy (IFA).Annals of intensive care · 2020Review
- Microcirculation: Physiology, Pathophysiology, and Clinical Application.Blood purification · 2020Review
- Journal of Clinical Monitoring and Computing 2017/2018 end of year summary: monitoring-and provocation-of the microcirculation and tissue oxygenation.Journal of clinical monitoring and computing · 2019Review
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundManagement of tissue perfusion following cardiac surgery is a challenging task where common clinical parameters do not reflect microcirculatory dysfunction. Heterogeneity in blood flow perfusion and abnormalities in capillary density characterize microcirculatory dysfunction. The restoration of a normal microcirculation may become a novel target for therapy in the future in addition to macrocirculatory parameters. The aim of this study is to determine how the sublingual microcirculatory parameters vary at the bedside in post-cardiac surgery patients which underwent diuretic therapy to correct fluid overload.
methodsIn this prospective observational pilot study, video clips of sublingual microcirculation in post-cardiac surgery patients receiving furosemide and/or spironolactone to achieve normal fluid balance were recorded using Cytocam-IDF imaging. Data was obtained on the first (T0), second (T1), and third (T2) day after the patients left the intensive care unit (ICU). Measurements were analyzed off-line to obtain the following microcirculatory parameters: total vessel density (TVD), microcirculatory flow index (MFI), proportion of perfused vessel (PPV), and perfused vessel density (PVD). Macrocirculatory parameters and body weight were also collected at these time points.
resultsNinety measurements were performed in ten post ICU cardiac surgery patients. Thirteen measurements were excluded due to quality reasons; these excluded measurements were spread across the patients and time points, and there was no loss of patients or time points. An increase in TVD was observed from T0 to T1 (20 ± 2.7 to 24 ± 3.2 mm/mm
conclusionsCytocam-IDF imaging to monitor microcirculation as a daily parameter is feasible and could become a valuable tool to non-invasively assess the tissue oxygenation at the bedside. An increase in TVD and PVD (functional capillary density) indicated the recruitment of the sublingual microcirculation in patients with diuretic therapy. Future research is needed to prove the correlation between the recruitment of the sublingual microcirculation and the de-escalation phase of the fluid management.
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