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Article type: Research Article
Authors: Bruno, Raphael Romanoa | Masyuk, Marynaa | Muessig, Johanna M.a | Binneboessel, Stephana | Bernhard, Michaelb | Bäz, Laurac | Franz, Marcusc | Kelm, Maltea; d | Jung, Christiana; *
Affiliations: [a] Department of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany | [b] Emergency Department, University Hospital of Düsseldorf, Düsseldorf, Germany | [c] Department of Internal Medicine I, University Hospital Jena, Jena, Germany | [d] Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany
Correspondence: [*] Corresponding author: Christian Jung, MD, PhD, University Hospital Düsseldorf, Düsseldorf, Germany. Fax: +49 (0)211 81 18812; E-mail: [email protected].
Abstract: BACKGROUND:Dehydration occurs frequently in older patients and constitutes a significant clinical problem. OBJECTIVE:This proof-of-concept study examines whether 1) sublingual measurement in dehydrated old patients is feasible, 2) frailty and incompliance in old, awake patients affects video-quality, 3) dehydration impacts microcirculation METHODS:This prospective observational study included clinically dehydrated patients aged ≥65 years immediately after admission. Dehydration was assessed clinically. A sidestream dark field camera (SDF) was used for measurement. Video-quality was evaluated with MIQS (microcirculation image quality score). Both AVA 4.3C- and AVA POEM-software analyzed the videos. Seventeen patients ≥65 years not showing dehydration served as control. RESULTS:Thirteen patients (8 female) were included. The average age was 83±8 years. The mini-mental test was 17±15 points, the Clinical Frailty Scale 4±3, the Barthel-Index 59±39. None of these parameters correlated with MIQS (3.4±4.2 SD (“acceptable”)). Dehydrated patients had a slightly impaired microcirculation, with a significantly lower percentage of perfused small vessels compared to control (83.1±7.7% versus 88.0±6.0%, P < 0.05). After rehydration, there was acute improvement in the microcirculation. CONCLUSIONS:Sublingual microcirculatory SDF-measurement is both, safe and valid for dehydrated old patients - regardless of frailty, age or cognitive performance. Dehydration leads to an impaired microcirculation.
Keywords: Microcirculation, elderly, dehydration, older, rehydration, cognitive impairment, SDF-measurement.
DOI: 10.3233/CH-200859
Journal: Clinical Hemorheology and Microcirculation, vol. 75, no. 4, pp. 475-487, 2020
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