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
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
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DOI：
10.1007/s00134-018-5070-7
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发表时间：
2018-03-01
影响因子：
38.9
通讯作者：
Scheeren, Thomas W. L.
中科院分区：
文献类型：
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作者：
Ince, Can;Boerma, E. Christiaan;Scheeren, Thomas W. L.
目的：应用手持式生命显微镜（HVMs）观察危重病人在不同休克状态下的舌下微循环变化。这一共识旨在为临床医生提供舌下微循环的实际应用和解释指南。此外，它的目的是促进集成的常规应用HVM微循环监测在传统的血流动力学监测全身血流动力学variables.Methods：按照德尔菲法，我们组织了三次国际专家会议，讨论的各个方面的技术，生理，测量，和临床效用的HVM舌下微循环监测，制定这一共识文件。欧洲重症监护医学会心血管动力学分会的一个工作组（经其执行委员会批准）创建了该共识，作为2007年先前共识的更新。我们分类共识声明的定义，要求和/或建议，与80%的协议的所有participator.Results的最低要求：在此共识的性质微循环改变的描述。变量的性质，它可以从微循环图像的分析中提取，并定义所需的数据集的变量，以识别微循环的改变。舌下HVM测量的实际方面和文物的性质进行了描述。制定了与图像采集和质量声明有关的11项声明。14个语句处理的图像分析，和13个语句是有关未来的developments.Conclusion：这一共识描述了25个语句的收购和解释微循环图像需要指导评估危重患者的微循环。
Purpose: 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.Methods: 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.Results: 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.Conclusion: 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.