Bedside Sublingual Video Imaging of Microcirculation in Assessing Bacterial Infection in Cirrhosis

Bacterial infections are common in cirrhosis and can lead to life-threatening complications. Sidestream dark-field (SDF) imaging has recently emerged as a noninvasive tool for capturing real-time video images of sublingual microcirculation in critically ill patients with sepsis. The objective of thi...

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Autores principales: Sheikh, Muhammad Y., Javed, Usman, Singh, Jasjit, Choudhury, Jayanta, Deen, Omer, Dhah, Kulraj, Peterson, Michael W.
Formato: Texto
Lenguaje:English
Publicado: Springer US 2009
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778688/
https://www.ncbi.nlm.nih.gov/pubmed/19117129
http://dx.doi.org/10.1007/s10620-008-0664-5
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author Sheikh, Muhammad Y.
Javed, Usman
Singh, Jasjit
Choudhury, Jayanta
Deen, Omer
Dhah, Kulraj
Peterson, Michael W.
author_facet Sheikh, Muhammad Y.
Javed, Usman
Singh, Jasjit
Choudhury, Jayanta
Deen, Omer
Dhah, Kulraj
Peterson, Michael W.
author_sort Sheikh, Muhammad Y.
collection PubMed
description Bacterial infections are common in cirrhosis and can lead to life-threatening complications. Sidestream dark-field (SDF) imaging has recently emerged as a noninvasive tool for capturing real-time video images of sublingual microcirculation in critically ill patients with sepsis. The objective of this study was to assess the utility of SDF in determining underlying infection in patients with cirrhosis. Sublingual microcirculation was compared among patients with compensated cirrhosis (Group A, n = 13), cirrhosis without sepsis (Group B, n = 18), cirrhosis with sepsis (Group C, n = 14), and sepsis only (Group D, n = 10). The blood flow was semi-quantitatively evaluated in four equal quadrants in small (10–25 mm); medium (26–50 mm); and large (51–100 mm) sublingual capillaries. The blood flow was described as no flow (0), intermittent flow (1), sluggish flow (2), and continuous flow (3). The overall flow score or microvascular flow index (MFI) was measured for quantitative assessment of microcirculation and predicting power for concurrent infection in cirrhosis. Marked impairment was observed at all levels of microvasculature in Groups B and C when compared with Group A. This effect was restricted to small vessels only when Group B was compared with Group C. MFI < 1.5 was found to have highest sensitivity (100%) and specificity (100%) for infection in decompensated cirrhosis. SDF imaging of sublingual microcirculation can be a useful bedside diagnostic tool to assess bacterial infection in cirrhosis.
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spelling pubmed-27786882009-11-20 Bedside Sublingual Video Imaging of Microcirculation in Assessing Bacterial Infection in Cirrhosis Sheikh, Muhammad Y. Javed, Usman Singh, Jasjit Choudhury, Jayanta Deen, Omer Dhah, Kulraj Peterson, Michael W. Dig Dis Sci Original Article Bacterial infections are common in cirrhosis and can lead to life-threatening complications. Sidestream dark-field (SDF) imaging has recently emerged as a noninvasive tool for capturing real-time video images of sublingual microcirculation in critically ill patients with sepsis. The objective of this study was to assess the utility of SDF in determining underlying infection in patients with cirrhosis. Sublingual microcirculation was compared among patients with compensated cirrhosis (Group A, n = 13), cirrhosis without sepsis (Group B, n = 18), cirrhosis with sepsis (Group C, n = 14), and sepsis only (Group D, n = 10). The blood flow was semi-quantitatively evaluated in four equal quadrants in small (10–25 mm); medium (26–50 mm); and large (51–100 mm) sublingual capillaries. The blood flow was described as no flow (0), intermittent flow (1), sluggish flow (2), and continuous flow (3). The overall flow score or microvascular flow index (MFI) was measured for quantitative assessment of microcirculation and predicting power for concurrent infection in cirrhosis. Marked impairment was observed at all levels of microvasculature in Groups B and C when compared with Group A. This effect was restricted to small vessels only when Group B was compared with Group C. MFI < 1.5 was found to have highest sensitivity (100%) and specificity (100%) for infection in decompensated cirrhosis. SDF imaging of sublingual microcirculation can be a useful bedside diagnostic tool to assess bacterial infection in cirrhosis. Springer US 2009-01-01 2009 /pmc/articles/PMC2778688/ /pubmed/19117129 http://dx.doi.org/10.1007/s10620-008-0664-5 Text en © The Author(s) 2008 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.
spellingShingle Original Article
Sheikh, Muhammad Y.
Javed, Usman
Singh, Jasjit
Choudhury, Jayanta
Deen, Omer
Dhah, Kulraj
Peterson, Michael W.
Bedside Sublingual Video Imaging of Microcirculation in Assessing Bacterial Infection in Cirrhosis
title Bedside Sublingual Video Imaging of Microcirculation in Assessing Bacterial Infection in Cirrhosis
title_full Bedside Sublingual Video Imaging of Microcirculation in Assessing Bacterial Infection in Cirrhosis
title_fullStr Bedside Sublingual Video Imaging of Microcirculation in Assessing Bacterial Infection in Cirrhosis
title_full_unstemmed Bedside Sublingual Video Imaging of Microcirculation in Assessing Bacterial Infection in Cirrhosis
title_short Bedside Sublingual Video Imaging of Microcirculation in Assessing Bacterial Infection in Cirrhosis
title_sort bedside sublingual video imaging of microcirculation in assessing bacterial infection in cirrhosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2778688/
https://www.ncbi.nlm.nih.gov/pubmed/19117129
http://dx.doi.org/10.1007/s10620-008-0664-5
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