TY - JOUR
T1 - 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
AU - Ince, Can
AU - Boerma, E. Christiaan
AU - Cecconi, Maurizio
AU - de Backer, Daniel
AU - Shapiro, Nathan I.
AU - Duranteau, Jacques
AU - Pinsky, Michael R.
AU - Artigas, Antonio
AU - Teboul, Jean-Louis
AU - Reiss, Irwin K. M.
AU - Aldecoa, Cesar
AU - Hutchings, Sam D.
AU - Donati, Abele
AU - Maggiorini, Marco
AU - Taccone, Fabio S.
AU - Hernandez, Glenn
AU - Payen, Didier
AU - Tibboel, Dick
AU - Martin, Daniel S.
AU - Zarbock, Alexander
AU - Monnet, Xavier
AU - Dubin, Arnaldo
AU - Bakker, Jan
AU - Vincent, Jean-Louis
AU - Scheeren, Thomas W. L.
PY - 2018
Y1 - 2018
N2 - Hand-held vital microscopes (HVMs) were introduced to observe sublingual microcirculatory alterations at the bedside in different shock states in critically ill patients. This consensus aims to provide clinicians with guidelines for practical use and interpretation of the sublingual microcirculation. Furthermore, it aims to promote the integration of routine application of HVM microcirculatory monitoring in conventional hemodynamic monitoring of systemic hemodynamic variables. In accordance with the Delphi method we organized three international expert meetings to discuss the various aspects of the technology, physiology, measurements, and clinical utility of HVM sublingual microcirculatory monitoring to formulate this consensus document. A task force from the Cardiovascular Dynamics Section of the European Society of Intensive Care Medicine (with endorsement of its Executive Committee) created this consensus as an update of a previous consensus in 2007. We classified consensus statements as definitions, requirements, and/or recommendations, with a minimum requirement of 80% agreement of all participants. In this consensus the nature of microcirculatory alterations is described. The nature of variables, which can be extracted from analysis of microcirculatory images, is presented and the needed dataset of variables to identify microcirculatory alterations is defined. Practical aspects of sublingual HVM measurements and the nature of artifacts are described. Eleven statements were formulated that pertained to image acquisitions and quality statements. Fourteen statements addressed the analysis of the images, and 13 statements are related to future developments. This consensus describes 25 statements regarding the acquisition and interpretation of microcirculatory images needed to guide the assessment of the microcirculation in critically ill patients
AB - Hand-held vital microscopes (HVMs) were introduced to observe sublingual microcirculatory alterations at the bedside in different shock states in critically ill patients. This consensus aims to provide clinicians with guidelines for practical use and interpretation of the sublingual microcirculation. Furthermore, it aims to promote the integration of routine application of HVM microcirculatory monitoring in conventional hemodynamic monitoring of systemic hemodynamic variables. In accordance with the Delphi method we organized three international expert meetings to discuss the various aspects of the technology, physiology, measurements, and clinical utility of HVM sublingual microcirculatory monitoring to formulate this consensus document. A task force from the Cardiovascular Dynamics Section of the European Society of Intensive Care Medicine (with endorsement of its Executive Committee) created this consensus as an update of a previous consensus in 2007. We classified consensus statements as definitions, requirements, and/or recommendations, with a minimum requirement of 80% agreement of all participants. In this consensus the nature of microcirculatory alterations is described. The nature of variables, which can be extracted from analysis of microcirculatory images, is presented and the needed dataset of variables to identify microcirculatory alterations is defined. Practical aspects of sublingual HVM measurements and the nature of artifacts are described. Eleven statements were formulated that pertained to image acquisitions and quality statements. Fourteen statements addressed the analysis of the images, and 13 statements are related to future developments. This consensus describes 25 statements regarding the acquisition and interpretation of microcirculatory images needed to guide the assessment of the microcirculation in critically ill patients
U2 - https://doi.org/10.1007/s00134-018-5070-7
DO - https://doi.org/10.1007/s00134-018-5070-7
M3 - Article
C2 - 29411044
SN - 0342-4642
VL - 44
SP - 281
EP - 299
JO - Intensive care medicine
JF - Intensive care medicine
IS - 3
ER -