2014
DOI: 10.3233/ch-141810
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Clinical evaluation of the intestinal microcirculation using sidestream dark field imaging – Recommendations of a round table meeting

Abstract: INTRODUCTION:In clinical setting, Sidestream Dark Field (SDF) imaging has provided unprecedented insights into the gut microcirculation mainly by studying the intestinal mucosa of patients with ileostomies. Visualizing microvascular structure and function of ileal mucosa at the bedside brings unique opportunity for clinical research, particularly in critically ill patients. Several papers that were focused on intestinal microcirculation, used different methods of assessment because an accepted scoring systems … Show more

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Cited by 19 publications
(10 citation statements)
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“…Those processes together constitute a local hypoxic microenvironment in the intestinal mucosa. Previous findings have shown different degrees of hypoxia in the intestinal mucosa of murine models and in patients with inflammatory bowel disease ( 20 22 ). During hypoxia the balance between oxygen supply and oxygen consumption in cells is damaged, which enables some hypoxia-inducible factors such as HIF-1α to regulate different physiological and pathological reactions through different mechanisms ( 23 ).…”
Section: Discussionmentioning
confidence: 96%
“…Those processes together constitute a local hypoxic microenvironment in the intestinal mucosa. Previous findings have shown different degrees of hypoxia in the intestinal mucosa of murine models and in patients with inflammatory bowel disease ( 20 22 ). During hypoxia the balance between oxygen supply and oxygen consumption in cells is damaged, which enables some hypoxia-inducible factors such as HIF-1α to regulate different physiological and pathological reactions through different mechanisms ( 23 ).…”
Section: Discussionmentioning
confidence: 96%
“…A duration of 10 sec of recording was attempted for each occasion and this was repeated for a total of three to five recordings, as able. Following analog to digital conversion, the pictures were stored until data analysis was undertaken using proprietary software (AVA) and according to published consensus approaches for this technique (De Backer et al 2007;Bezemer et al 2011;Lehmann et al 2014). An observer, masked to the clinical details, adjusted the image quality for maximum clarity, as per AVA software instructions.…”
Section: Methodsmentioning
confidence: 99%
“…The dysregulated immune response in systemic inflammation has significant impact on the microvascular blood flow in the intestine and other organs (40)(41)(42). This is directly related to the interaction of immune cells with the endothelium but also indirect factors, such as platelet activation leading to intravascular coagulation or changes in protein composition of plasma, contributing to the disturbances within the microcirculation in sepsis Figure 2.…”
Section: Intestinal Blood Flowmentioning
confidence: 99%
“…MFI measurement can be simplified by estimation of blood flow in single villi and by using a modified scale: 3 -continuous flow; 2 -hypoperfused (i.e., sluggish or intermittent flow); or 1 -no flow. The sum of all single villi MFIs is divided by the number of the villi (i.e., averaged MFI; (41). We can also describe the perfused vessel density of intestinal villi by dividing the number of villi with normal flow by the total number of villi in the visual field.…”
Section: Intestinal Blood Flowmentioning
confidence: 99%