- Poster presentation
- Open Access
Role of microcirculatory monitoring in polytraumatic patients
© Donati et al. 2011
- Published: 1 March 2011
- Biochemical Marker
- Sequential Organ Failure Assessment
- Vessel Density
- Dark Field Imaging
- Multiple Organ Dysfunction Syndrome
Seventy-five percent of ICU mortality after the first 72 hours following major trauma is due to multiple organ dysfunction syndrome (MODS) . How to follow this evolution is not completely understood yet and new parameters are still needed. The aim of this study was to evaluate the effects of polytrauma on sublingual microcirculation and to search correlations among it, Sequential Organ Failure Assessment (SOFA) score and biochemical markers and to use these factors for monitoring patients .
This prospective study included 12 patients. Sublingual microcirculation has been registered using sidestream dark field imaging and analysed with AVA software, searching for indices of vessel density, perfusion and type of flow. For each patient, SOFA parameters, hemocoagulation indices, cytonecrosis criteria and hypoperfusion measures have been evaluated at admission and every 48 hours, for a minimum of 96 hours, and correlation between these and microcirculatory parameters has been researched. We then evaluated the discriminating capacity of these parameters versus microcirculatory indices, calculating the area under the ROC curve.
Even in polytrauma, microcirculatory dysfunction is important for MODS appearance, and its analysis (PVD, TVD, De Backer score, MFIs) can help to evaluate this evolution, according to biochemical markers and severity index: joined with macrohaemodynamic indices, they allow one to better investigate organ features.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.