TY - JOUR
T1 - Variability of Microcirculatory Measurements in Critically Ill Patients
AU - Bol, Martine E.
AU - Beurskens, Danielle M. H.
AU - Delnoij, Thijs S. R.
AU - Roekaerts, Paul M. H. J.
AU - Reutelingsperger, Chris P. M.
AU - Delhaas, Tammo
AU - van de Poll, Marcel C. G.
AU - Sels, Jan-Willem E. M.
AU - Nicolaes, Gerry A. F.
PY - 2020/7
Y1 - 2020/7
N2 - Introduction: Monitoring the microcirculation may be helpful in guiding resuscitation in patients with circulatory shock. Sublingual side-stream dark field imaging cameras allow for noninvasive, bedside evaluation of the microcirculation, although their use in clinical practice has not yet been validated. The GlycoCheck system automatically analyzes images to determine glycocalyx thickness, red blood cell filling percentage, and vessel density. Although GlycoCheck has been used to study microcirculation in critically ill patients, little is known about the reproducibility of measurements in this population. Materials and Methods: A total of 60 critically ill patients were studied. Three consecutive microcirculation measurements were performed with the GlycoCheck system in 40 of these patients by one of two experienced observers. Twenty patients were assessed by both observers. Intra- and interobserver variability were assessed using intraclass correlation coefficients (ICCs). Results: ICCs of single measurements were poor for glycocalyx thickness and good for filling percentage and vessel density. Reproducibility could be substantially increased for all parameters when three consecutive measurements were performed and averaged. Discussion: GlycoCheck can be used to study microcirculation. However, to obtain reliable results three consecutive measurements should be performed and averaged. The variation of the measurements currently hampers the clinical application in individual patients.
AB - Introduction: Monitoring the microcirculation may be helpful in guiding resuscitation in patients with circulatory shock. Sublingual side-stream dark field imaging cameras allow for noninvasive, bedside evaluation of the microcirculation, although their use in clinical practice has not yet been validated. The GlycoCheck system automatically analyzes images to determine glycocalyx thickness, red blood cell filling percentage, and vessel density. Although GlycoCheck has been used to study microcirculation in critically ill patients, little is known about the reproducibility of measurements in this population. Materials and Methods: A total of 60 critically ill patients were studied. Three consecutive microcirculation measurements were performed with the GlycoCheck system in 40 of these patients by one of two experienced observers. Twenty patients were assessed by both observers. Intra- and interobserver variability were assessed using intraclass correlation coefficients (ICCs). Results: ICCs of single measurements were poor for glycocalyx thickness and good for filling percentage and vessel density. Reproducibility could be substantially increased for all parameters when three consecutive measurements were performed and averaged. Discussion: GlycoCheck can be used to study microcirculation. However, to obtain reliable results three consecutive measurements should be performed and averaged. The variation of the measurements currently hampers the clinical application in individual patients.
KW - Critically ill
KW - glycocalyx
KW - intra
KW - and interobserver variability
KW - microcirculation
KW - side-stream dark field imaging
KW - SUBLINGUAL MICROVASCULAR GLYCOCALYX
KW - SEPSIS
U2 - 10.1097/SHK.0000000000001470
DO - 10.1097/SHK.0000000000001470
M3 - Article
C2 - 31743299
SN - 1073-2322
VL - 54
SP - 9
EP - 14
JO - Shock
JF - Shock
IS - 1
ER -