Searching for just a few words should be enough to get started. If you need to make more complex queries, use the tips below to guide you.
Issue title: Selected papers of the 36th Conference of the German Society for Clinical Microcirculation and Hemorheology, 5–8. June, 2017, Greifswald, Germany - New developments in clinical microcirculation imaging
Guest editors: M. Jünger, A. Krüger-Genge and F. Jung
Article type: Research Article
Authors: Henzler, Dietricha; * | Scheffler, Matthiasb | Westheider, Arnea | Köhler, Thomasa
Affiliations: [a] Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Ruhr-University Bochum, Klinikum Herford, Herford, Germany | [b] Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax NS, Canada
Correspondence: [*] Corresponding author: Dietrich Henzler, MD, PhD, Professor of Anesthesiology, Ruhr-University Bochum, Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Klinikum Herford, Schwarzenmoorstr. 70, D-32049 Herford, Germany. Tel.: +49 5221 942481; Fax +49 5221 942801; E-mail: [email protected].
Abstract: BACKGROUND:In patients with shock, inflammation and sepsis alterations in microcirculation are common problems. Although the pathophysiologic consequences are well understood, measurements of microcirculation have not entered clinical routine so far. OBJECTIVE:To characterize the requirements for clinical microcirculation measurement techniques and the barriers for implementation into routine practice. METHODS:Clinical review of reliability, reproducibility, validity, availability and usefulness of clinically available measurement techniques to be used in patients with sepsis or cardiac surgery with cardiopulmonary bypass. RESULTS:Few methods such as video microscopy are readily available at the bedside, but are hampered by the high variability of measurements and the lack of reliable automated software analysis. The correlation of microcirculation impairment measured by in-vivo microscopy with fatal outcomes has been established, but no recommendations have been given which parameters should be targeted to improve outcomes. Measurement of regional brain tissue oxygenation has been recommended for cardiac surgery, but does not specifically target microcirculation. CONCLUSIONS:International guidelines for the management of sepsis or cardiac anesthesia do not recommend specific goals targeting the microcirculation directly, but global hemodynamics. The reason for this may be attributed to the lack of methods that fulfill the requirements necessary to be clinically acceptable. Once the validity, i.e. any improvement in patient’s outcomes attributable to microcirculation measurements, can be established, clinical measurement of microcirculation could become part of routine treatment of patients with sepsis, inflammation and shock. Until then, more clinical studies targeting microcirculation are urgently needed.
Keywords: Sepsis, shock, microcirculation, technology, in-vivo microscopy, cardiac anesthesia, inflammation
DOI: 10.3233/CH-179229
Journal: Clinical Hemorheology and Microcirculation, vol. 67, no. 3-4, pp. 505-509, 2017
IOS Press, Inc.
6751 Tepper Drive
Clifton, VA 20124
USA
Tel: +1 703 830 6300
Fax: +1 703 830 2300
[email protected]
For editorial issues, like the status of your submitted paper or proposals, write to [email protected]
IOS Press
Nieuwe Hemweg 6B
1013 BG Amsterdam
The Netherlands
Tel: +31 20 688 3355
Fax: +31 20 687 0091
[email protected]
For editorial issues, permissions, book requests, submissions and proceedings, contact the Amsterdam office [email protected]
Inspirees International (China Office)
Ciyunsi Beili 207(CapitaLand), Bld 1, 7-901
100025, Beijing
China
Free service line: 400 661 8717
Fax: +86 10 8446 7947
[email protected]
For editorial issues, like the status of your submitted paper or proposals, write to [email protected]
如果您在出版方面需要帮助或有任何建, 件至: [email protected]