Impact of microcirculatory video quality on the evaluation of sublingual microcirculation in critically ill patients
Autor: | Elisa Damiani, Can Ince, Erica Adrario, Rocco Romano, Nicoletta Mininno, Paolo Pelaia, Andrea Carsetti, Roberta Domizi, Claudia Scorcella, Silvia Pierantozzi, Abele Donati |
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Přispěvatelé: | ACS - Amsterdam Cardiovascular Sciences, Translational Physiology, ACS - Microcirculation |
Rok vydání: | 2016 |
Předmět: |
Adult
medicine.medical_specialty Critical Care medicine.medical_treatment Critical Illness Video Recording Health Informatics Critical Care and Intensive Care Medicine Video quality law.invention Microcirculation 03 medical and health sciences Young Adult 0302 clinical medicine Tongue law Internal medicine Anesthesiology medicine Humans Glasgow Coma Scale Prospective Studies Mouth Floor Aged Retrospective Studies Mechanical ventilation Microscopy Video business.industry Microvascular Density 030208 emergency & critical care medicine Middle Aged Intensive care unit Respiration Artificial Surgery Intensive Care Units Anesthesiology and Pain Medicine 030228 respiratory system Quality Score Cardiology business Perfusion |
Zdroj: | Journal of clinical monitoring and computing, 31(5), 981-988. Springer Netherlands |
ISSN: | 1573-2614 1387-1307 |
Popis: | We aimed to assess the impact of image quality on microcirculatory evaluation with sidestream dark-field (SDF) videomicroscopy in critically ill patients and explore factors associated with low video quality. This was a retrospective analysis of a single-centre prospective observational study. Videos of the sublingual microcirculation were recorded using SDF videomicroscopy in 100 adult patients within 12 h from admittance to the intensive care unit and every 24 h until discharge/death. Parameters of vessel density and perfusion were calculated offline for small vessels. For all videos, a quality score (-12 = unacceptable, 1 = suboptimal, 2 = optimal) was assigned for brightness, focus, content, stability, pressure and duration. Videos with a total score ≤8 were deemed as unacceptable. A total of 2455 videos (853 triplets) was analysed. Quality was acceptable in 56 % of videos. Lower quality was associated with worse microvascular density and perfusion. Unreliable triplets (≥1 unacceptable or missing video, 65 % of total) showed lower vessel density, worse perfusion and higher flow heterogeneity as compared to reliable triplets (p < 0.001). Quality was higher among triplets collected by an extensively-experienced investigator or in patients receiving sedation or mechanical ventilation. Perfused vessel density was higher in patients with Glasgow Coma Scale (GCS) ≤8 (18.9 ± 4.5 vs. 17.0 ± 3.9 mm/mm(2) in those with GCS >8, p < 0.001) or requiring mechanical ventilation (18.0 ± 4.5 vs. 17.2 ± 3.8 mm/mm(2) in not mechanically ventilated patients, p = 0.059). We concluded that SDF video quality depends on both the operator's experience and patient's cooperation. Low-quality videos may produce spurious data, leading to an overestimation of microvascular alterations |
Databáze: | OpenAIRE |
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