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. 2005;9(6):R601-6.
doi: 10.1186/cc3809. Epub 2005 Sep 22.

Quantifying bedside-derived imaging of microcirculatory abnormalities in septic patients: a prospective validation study

E Christiaan Boerma  1 , Keshen R Mathura, Peter H J van der Voort, Peter E Spronk, Can Ince
Affiliations

Quantifying bedside-derived imaging of microcirculatory abnormalities in septic patients: a prospective validation study

E Christiaan Boerma et al. Crit Care. 2005.

Abstract

Introduction: The introduction of orthogonal polarization spectral (OPS) imaging in clinical research has elucidated new perspectives on the role of microcirculatory flow abnormalities in the pathogenesis of sepsis. Essential to the process of understanding and reproducing these abnormalities is the method of quantification of flow scores.

Methods: In a consensus meeting with collaboraters from six research centres in different fields of experience with microcirculatory OPS imaging, premeditated qualifications for a simple, translucent and reproducible way of flow scoring were defined. Consecutively, a single-centre prospective observational validation study was performed in a group of 12 patients with an abdominal sepsis and a new stoma. Flow images of the microcirculation in vascular beds of the sublingual and stoma region were obtained, processed and analysed in a standardised way. We validated intra-observer and inter-observer reproducibility with kappa cross-tables for both types of microvascular beds.

Results: Agreement and kappa coefficients were >85% and >0.75, respectively, for interrater and intrarater variability in quantification of flow abnormalities during sepsis, in different subsets of microvascular architecture.

Conclusion: Semi-quantitative analysis of microcirculatory flow, as described, provides a reproducible and transparent tool in clinical research to monitor and evaluate the microcirculation during sepsis.

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Figures

Figure 1
Figure 1
Orthogonal polarization imaging of a microvascular network; the sublingual microvascular architecture. The image is divided in four quadrants (a, b, c and d) with examples of vessel classification: small (s; 10 to 25 μm); medium (m; 26 to 50 μm); large (l; 51 to 100 μm). Objective 5×, on screen 325×.
Figure 2
Figure 2
Orthogonal polarization imaging of a repeating vascular structure; the villi of the small intestine. Objective 5×, on screen 325×.
See this image and copyright information in PMC

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