Safety and feasibility of sublingual microcirculation assessment in the emergency department for civilian and military patients with traumatic haemorrhagic shock: A prospective cohort study

BMJ Open

Volumn 6, Issue 12, 2016, Pages

  Naumann, David N ^a   Mellis, Clare ^b   Smith, Iain M ^a,c   Mamuza, Jasna ^d   Skene, Imogen ^d   Harris, Tim ^d   Midwinter, Mark J ^e   Hutchings, Sam D ^b  

^a QUEEN ELIZABETH HOSPITAL   (United Kingdom)

^b KING S COLLEGE HOSPITAL   (United Kingdom)

^c QUEEN ELIZABETH UNIVERSITY HOSPITAL   (United Kingdom)

^d QUEEN MARY UNIVERSITY OF LONDON   (United Kingdom)

^e UNIVERSITY OF QUEENSLAND   (Australia)

Author keywords

haemorrhage; Microcirculation; shock; sublingual; TRAUMA MANAGEMENT

Indexed keywords

ADULT; ARMY; ARTICLE; CLINICAL ARTICLE; COHORT ANALYSIS; EMERGENCY WARD; FEMALE; HEMORRHAGIC SHOCK; HUMAN; INJURY SCALE; MALE; MICROCIRCULATION; OBSERVATIONAL STUDY; PILOT STUDY; PROSPECTIVE STUDY; SAFETY; SUBLINGUAL GLAND; TRAFFIC ACCIDENT; VIDEO MICROSCOPY; AFGHANISTAN; BLOOD FLOW; COMPLICATION; EMERGENCY HEALTH SERVICE; EVALUATION STUDY; FEASIBILITY STUDY; HEALTH CARE FACILITY; HOSPITAL EMERGENCY SERVICE; INJURY; MIDDLE AGED; MOUTH FLOOR; PATHOPHYSIOLOGY; PATIENT SAFETY; PHYSIOLOGIC MONITORING; PROCEDURES; SOLDIER; STANDARDS; UNITED KINGDOM;

ADULT; AFGHANISTAN; EMERGENCY MEDICAL SERVICES; EMERGENCY SERVICE, HOSPITAL; FEASIBILITY STUDIES; FEMALE; HEALTH FACILITIES; HUMANS; INJURY SEVERITY SCORE; MALE; MICROCIRCULATION; MICROSCOPY, VIDEO; MIDDLE AGED; MILITARY PERSONNEL; MONITORING, PHYSIOLOGIC; MOUTH FLOOR; PATIENT SAFETY; PILOT PROJECTS; PROSPECTIVE STUDIES; REGIONAL BLOOD FLOW; SHOCK, HEMORRHAGIC; UNITED KINGDOM; WOUNDS AND INJURIES;

EID: 85007048868     PISSN: None     EISSN: 20446055     Source Type: Journal    
DOI: 10.1136/bmjopen-2016-014162     Document Type: Article

References (15)

1. Chignalia AZ, Yetimakman F, Christiaans SC, et al. The glycocalyx and trauma: a review. Shock 2016;45:338-48.
2. Tachon G, Harrois A, Tanaka S, et al. Microcirculatory alterations in traumatic hemorrhagic shock. Crit Care Med 2014;42:1433-41.
3. Hutchings SD, Naumann DN, Watts S, et al. Microcirculatory perfusion shows wide inter-individual variation and is important in determining shock reversal during resuscitation in a porcine experimental model of complex traumatic hemorrhagic shock. Intensive Care Med Exp 2016;4:17.
4. Ince C. Hemodynamic coherence and the rationale for monitoring the microcirculation. Crit Care 2015;19(Suppl 3):S8.
5. Trzeciak S, Dellinger RP, Parrillo JE, et al. Early microcirculatory perfusion derangements in patients with severe sepsis and septic shock: relationship to hemodynamics, oxygen transport, and survival. Ann Emerg Med 2007;49:88-98, 98.e1-2.
6. Hogan CJ, Ward KR, Franzen DS, et al. Sublingual tissue perfusion improves during emergency treatment of acute decompensated heart failure. Am J Emerg Med 2012;30:872-80.
7. Hutchings S, Naumann DN, Harris T, et al. Observational study of the effects of traumatic injury, haemorrhagic shock and resuscitation on the microcirculation: a protocol for the MICROSHOCK study. BMJ Open 2016;6:e010893.
8. Hutchings S, Watts S, Kirkman E. The Cytocam video microscope. A new method for visualising the microcirculation using Incident Dark Field technology. Clin Hemorheol Microcirc 2016;62:261-71.
9. De Backer D, Hollenberg S, Boerma C, et al. How to evaluate the microcirculation: report of a round table conference. Crit Care 2007;11:R101.
10. Massey MJ, Larochelle E, Najarro G, et al. The microcirculation image quality score: development and preliminary evaluation of a proposed approach to grading quality of image acquisition for bedside videomicroscopy. J Crit Care 2013;28:913-17.
11. Massey MJ, Shapiro NI. A guide to human in vivo microcirculatory flow image analysis. Crit Care 2016;20:35.
12. Ferrada P, Evans D, Wolfe L, et al. Findings of a randomized controlled trial using limited transthoracic echocardiogram (LTTE) as a hemodynamic monitoring tool in the trauma bay. J Trauma Acute Care Surg 2014;76:31-7; discussion 7-8.
13. Naumann DN, Mellis C, Husheer SL, et al. Real-time point of care microcirculatory assessment of shock: design, rationale and application of the point of care microcirculation (POEM) tool. Crit Care 2016;20:310.
14. Arnold RC, Parrillo JE, Phillip Dellinger R, et al. Point-of-care assessment of microvascular blood flow in critically ill patients. Intensive Care Med 2009;35:1761-6.
15. Tuma M, Canestrini S, Alwahab Z, et al. Trauma and endothelial glycocalyx: the microcirculation helmet? Shock 2016;46:352-7.