Feasibility of optical coherence tomography angiography to assess changes in retinal microcirculation in ovine haemorrhagic shock.

Abstract:

BACKGROUND:This study aimed to investigate the feasibility of optical coherence tomography angiography (OCT-A) for quantitative analysis of flow density to assess changes in retinal perfusion in an experimental model of haemorrhagic shock. METHODS:Haemorrhagic shock was induced in five healthy, anaesthetized sheep by stepwise blood withdrawal of 3 × 10 ml∙kg- 1 body weight. OCT-A imaging of retinal perfusion was performed using an OCT device. Incident dark-field illumination microscopy videos were obtained for the evaluation of conjunctival microcirculation. Haemodynamic variables and flow density data in the OCT angiogram were analysed before and during progressive haemorrhage resulting in haemorrhagic shock as well as after fluid resuscitation with 10 ml∙kg- 1 body weight of balanced hydroxyethyl starch solution (6% HES 130/0.4). Videos of the conjunctival microcirculation were recorded at baseline, in haemorrhagic shock, and after resuscitation. Data are presented as median with interquartile range. Comparisons between time points were made using Friedman's test and the degree of correlation between two variables was expressed as Spearman's rank correlation coefficient. RESULTS:Mean arterial pressure and cardiac index (CI) decreased and lactate concentration increased after induction of shock, and haemodynamics recovered after resuscitation. The flow density in the superficial retinal OCT angiogram decreased significantly after shock induction (baseline 44.7% (40.3; 50.5) vs haemorrhagic shock 34.5% (32.8; 40.4); P = 0.027) and recovered after fluid resuscitation (46.9% (41.7; 50.7) vs haemorrhagic shock; P = 0.027). The proportion of perfused vessels of the conjunctival microcirculation showed similar changes. The flow density measured using OCT-A correlated with the conjunctival microcirculation (perfused vessel density: Spearman's rank correlation coefficient ρ = 0.750, P = 0.001) and haemodynamic parameters (CI: ρ = 0.693, P < 0.001). CONCLUSIONS:Retinal flow density, measured using OCT-A, significantly decreased in shock and recovered after fluid therapy in an experimental model of haemorrhagic shock. OCT-A is feasible to assess changes in retinal perfusion in haemorrhagic shock and fluid resuscitation.

journal_name

Crit Care

authors

Alnawaiseh M,Ertmer C,Seidel L,Arnemann PH,Lahme L,Kampmeier TG,Rehberg SW,Heiduschka P,Eter N,Hessler M

doi

10.1186/s13054-018-2056-3

subject

Has Abstract

pub_date

2018-05-29 00:00:00

pages

138

issue

1

eissn

1364-8535

issn

1466-609X

pii

10.1186/s13054-018-2056-3

journal_volume

22

pub_type

杂志文章
  • Role of selective V2-receptor-antagonism in septic shock: a randomized, controlled, experimental study.

    abstract:INTRODUCTION:V(2)-receptor (V(2)R) stimulation potentially aggravates sepsis-induced vasodilation, fluid accumulation and microvascular thrombosis. Therefore, the present study was performed to determine the effects of a first-line therapy with the selective V(2)R-antagonist (Propionyl(1)-D-Tyr(Et)(2)-Val(4)-Abu(6)-Arg...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/cc9320

    authors: Rehberg S,Ertmer C,Lange M,Morelli A,Whorton E,Dünser M,Strohhäcker AK,Lipke E,Kampmeier TG,Van Aken H,Traber DL,Westphal M

    更新日期:2010-01-01 00:00:00

  • Hippocrates is alive and weaning in Brazil.

    abstract::In a group of postoperative patients, Taniguchi and coworkers compared the effect of a computerized system for weaning against 'manual care'. The computerized system involved automatic adjustments to the level of pressure support to achieve a target respiratory rate. Manual care involved adjustments to the level of pr...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc7746

    authors: Adigüzel N,Güngör G,Tobin MJ

    更新日期:2009-01-01 00:00:00

  • Urinalysis and pre-renal acute kidney injury: time to move on.

    abstract::Urinary indices are classically believed to allow differentiation of transient (or pre-renal) acute kidney injury (AKI) from persistent (or acute tubular necrosis) AKI. However, the data validating urinalysis in critically ill patients are weak. In the previous issue of Critical Care, Pons and colleagues demonstrate i...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc12676

    authors: Schneider AG,Bellomo R

    更新日期:2013-05-07 00:00:00

  • Antiepileptic drugs in critically ill patients.

    abstract:BACKGROUND:The incidence of seizures in intensive care units ranges from 3.3% to 34%. It is therefore often necessary to initiate or continue anticonvulsant drugs in this setting. When a new anticonvulsant is initiated, drug factors, such as onset of action and side effects, and patient factors, such as age, renal, and...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-018-2066-1

    authors: Farrokh S,Tahsili-Fahadan P,Ritzl EK,Lewin JJ 3rd,Mirski MA

    更新日期:2018-06-07 00:00:00

  • Inhaled nitric oxide and the risk of renal dysfunction in patients with acute respiratory distress syndrome: a propensity-matched cohort study.

    abstract:BACKGROUND:Inhaled nitric oxide (iNO) is a rescue therapy for severe hypoxemia in patients with acute respiratory distress syndrome (ARDS). Pooled data from clinical trials have signaled a renal safety warning for iNO therapy, but the significance of these findings in daily clinical practice is unclear. We used primary...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1566-0

    authors: Ruan SY,Wu HY,Lin HH,Wu HD,Yu CJ,Lai MS

    更新日期:2016-11-30 00:00:00

  • Microcirculatory perfusion disturbances following cardiac surgery with cardiopulmonary bypass are associated with in vitro endothelial hyperpermeability and increased angiopoietin-2 levels.

    abstract:BACKGROUND:Endothelial hyperpermeability following cardiopulmonary bypass (CPB) contributes to microcirculatory perfusion disturbances and postoperative complications after cardiac surgery. We investigated the postoperative course of renal and pulmonary endothelial barrier function and the association with microcircula...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-019-2418-5

    authors: Dekker NAM,van Leeuwen ALI,van Strien WWJ,Majolée J,Szulcek R,Vonk ABA,Hordijk PL,Boer C,van den Brom CE

    更新日期:2019-04-11 00:00:00

  • Rapid response systems: you won't know there is a problem until you measure it.

    abstract::The rapid response system concept is one of the first patient-centered and organizational-wide systems aimed at preventing deaths and serious adverse events. It has been strongly argued that we need a benchmark that reflects the care of a deteriorating patient across the organization using a 'score to door time'; that...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc10477

    authors: Hillman KM

    更新日期:2011-01-01 00:00:00

  • A week seems to be weak: tailoring duration of antibiotic treatment in Gram-negative ventilator-associated pneumonia.

    abstract::The optimal length of antimicrobial therapy has not been extensively studied for a great majority of infections and, in critically ill patients affected by ventilator-associated pneumonia, is a persisting and unsolved issue confronting clinicians. The integration of biomarkers, clinical judgment, and microbiologic era...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc11899

    authors: Martin-Loeches I,Torres A

    更新日期:2013-01-21 00:00:00

  • Changes in the incidence and outcome for early acute kidney injury in a cohort of Australian intensive care units.

    abstract:INTRODUCTION:There is limited information on whether the incidence of acute kidney injury (AKI) in critically ill patients has changed over time and there is controversy on whether its outcome has improved. METHODS:We interrogated the Australian New Zealand Intensive Care Society Adult Patient Database to obtain data ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc5949

    authors: Bagshaw SM,George C,Bellomo R,ANZICS Database Management Committee.

    更新日期:2007-01-01 00:00:00

  • Moderate hyperoxic versus near-physiological oxygen targets during and after coronary artery bypass surgery: a randomised controlled trial.

    abstract:BACKGROUND:The safety of perioperative hyperoxia is currently unclear. Previous studies in patients undergoing coronary artery bypass surgery suggest reduced myocardial damage when avoiding extreme perioperative hyperoxia (>400 mmHg). In this study we investigated whether an oxygenation strategy from moderate hyperoxia...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/s13054-016-1240-6

    authors: Smit B,Smulders YM,de Waard MC,Boer C,Vonk AB,Veerhoek D,Kamminga S,de Grooth HJ,García-Vallejo JJ,Musters RJ,Girbes AR,Oudemans-van Straaten HM,Spoelstra-de Man AM

    更新日期:2016-03-10 00:00:00

  • A regional trauma system to optimize the pre-hospital triage of trauma patients.

    abstract:INTRODUCTION:Pre-hospital triage is a key element in a trauma system that aims to admit patients to the most suitable trauma center, and may decrease intra-hospital mortality. We evaluated the performance of a pre-hospital procedure in a regional trauma system through measurements of the quality of pre-hospital medical...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-015-0835-7

    authors: Bouzat P,Ageron FX,Brun J,Levrat A,Berthet M,Rancurel E,Thouret JM,Thony F,Arvieux C,Payen JF,TRENAU group.

    更新日期:2015-03-18 00:00:00

  • Complications of regional citrate anticoagulation: accumulation or overload?

    abstract::Regional citrate anticoagulation (RCA) is now recommended over systemic heparin for continuous renal replacement therapy in patients without contraindications. Its use is likely to increase throughout the world. However, in the absence of citrate blood level monitoring, the diagnosis of citrate accumulation, the most ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-017-1880-1

    authors: Schneider AG,Journois D,Rimmelé T

    更新日期:2017-11-19 00:00:00

  • Community-acquired polymicrobial pneumonia in the intensive care unit: aetiology and prognosis.

    abstract:INTRODUCTION:The frequency and clinical significance of polymicrobial aetiology in community-acquired pneumonia (CAP) patients admitted to the ICU have been poorly studied. The aim of the present study was to describe the prevalence, clinical characteristics and outcomes of severe CAP of polymicrobial aetiology in pati...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc10444

    authors: Cillóniz C,Ewig S,Ferrer M,Polverino E,Gabarrús A,Puig de la Bellacasa J,Mensa J,Torres A

    更新日期:2011-01-01 00:00:00

  • Is venous congestion associated with reduced cerebral oxygenation and worse neurological outcome after cardiac arrest?

    abstract:BACKGROUND:Post-cardiac arrest (CA) patients are at risk of secondary ischemic damage in the case of suboptimal brain oxygenation during an ICU stay. We hypothesized that elevated central venous pressures (CVP) would impair cerebral perfusion and oxygenation (venous cerebral congestion). The aim of the present study wa...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/s13054-016-1297-2

    authors: Ameloot K,Genbrugge C,Meex I,Eertmans W,Jans F,De Deyne C,Dens J,Mullens W,Ferdinande B,Dupont M

    更新日期:2016-05-15 00:00:00

  • Pulmonary artery catheter versus pulse contour analysis: a prospective epidemiological study.

    abstract:INTRODUCTION:The choice of invasive systemic haemodynamic monitoring in critically ill patients remains controversial as no multicentre comparative clinical data exist. Accordingly, we sought to study and compare the features and outcomes of patients who receive haemodynamic monitoring with either the pulmonary artery ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc5126

    authors: Uchino S,Bellomo R,Morimatsu H,Sugihara M,French C,Stephens D,Wendon J,Honore P,Mulder J,Turner A,PAC\/PiCCO Use and Likelihood of Success Evaluation PULSE Study Group.

    更新日期:2006-01-01 00:00:00

  • In vitro norepinephrine significantly activates isolated platelets from healthy volunteers and critically ill patients following severe traumatic brain injury.

    abstract:INTRODUCTION:Norepinephrine, regularly used to increase systemic arterial blood pressure and thus improve cerebral perfusion following severe traumatic brain injury (TBI), may activate platelets. This, in turn, could promote microthrombosis formation and induce additional brain damage. METHODS:The objective of this st...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc6931

    authors: Tschuor C,Asmis LM,Lenzlinger PM,Tanner M,Härter L,Keel M,Stocker R,Stover JF

    更新日期:2008-01-01 00:00:00

  • Intensive care unit acquired muscle weakness: when should we consider rehabilitation?

    abstract::Muscle weakness is highly prevalent during acute critical illness, with the poor exercise performance that occurs after critical illness being recognized as a consequence of skeletal muscles weakness. Advanced techniques to measure peripheral muscle strength are available, but they have limited use in the clinical set...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc7937

    authors: Puthucheary Z,Hart N

    更新日期:2009-01-01 00:00:00

  • Early sedation and clinical outcomes of mechanically ventilated patients: a prospective multicenter cohort study.

    abstract:INTRODUCTION:Sedation overuse is frequent and possibly associated with poor outcomes in the intensive care unit (ICU) patients. However, the association of early oversedation with clinical outcomes has not been thoroughly evaluated. The aim of this study was to assess the association of early sedation strategies with o...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,多中心研究

    doi:10.1186/cc13995

    authors: Tanaka LM,Azevedo LC,Park M,Schettino G,Nassar AP,Réa-Neto A,Tannous L,de Souza-Dantas VC,Torelly A,Lisboa T,Piras C,Carvalho FB,Maia Mde O,Giannini FP,Machado FR,Dal-Pizzol F,de Carvalho AG,dos Santos RB,Tierno PF,

    更新日期:2014-07-21 00:00:00

  • Clinical review: Vasculitis on the intensive care unit--part 1: diagnosis.

    abstract::The first part of this review addresses the diagnosis and differential diagnosis of the primary vasculitides Wegener's granulomatosis, microscopic polyangiitis, Churg-Strauss syndrome and polyarteritis nodosa. Prompt diagnosis and treatment of these conditions ensures an optimal prognosis. The development of assays fo...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/cc2936

    authors: Semple D,Keogh J,Forni L,Venn R

    更新日期:2005-02-01 00:00:00

  • Open lung biopsy in early-stage acute respiratory distress syndrome.

    abstract:INTRODUCTION:Acute respiratory distress syndrome (ARDS) has heterogeneous etiologies, rapid progressive change and a high mortality rate. To improve the outcome of ARDS, accurate diagnosis is essential to the application of effective early treatment. The present study investigated the clinical effects and safety of ope...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc4981

    authors: Kao KC,Tsai YH,Wu YK,Chen NH,Hsieh MJ,Huang SF,Huang CC

    更新日期:2006-01-01 00:00:00

  • Correlation between high blood IL-6 level, hyperglycemia, and glucose control in septic patients.

    abstract:INTRODUCTION:The aim of the present study was to investigate the relationship between the blood IL-6 level, the blood glucose level, and glucose control in septic patients. METHODS:This retrospective observational study in a general ICU of a university hospital included a total of 153 patients with sepsis, severe seps...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc11301

    authors: Nakamura M,Oda S,Sadahiro T,Watanabe E,Abe R,Nakada TA,Morita Y,Hirasawa H

    更新日期:2012-12-12 00:00:00

  • Diagnosis and management of inhalation injury: an updated review.

    abstract::In this article we review recent advances made in the pathophysiology, diagnosis, and treatment of inhalation injury. Historically, the diagnosis of inhalation injury has relied on nonspecific clinical exam findings and bronchoscopic evidence. The development of a grading system and the use of modalities such as chest...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-015-1077-4

    authors: Walker PF,Buehner MF,Wood LA,Boyer NL,Driscoll IR,Lundy JB,Cancio LC,Chung KK

    更新日期:2015-10-28 00:00:00

  • Clinical review: Tokyo - protecting the health care worker during a chemical mass casualty event: an important issue of continuing relevance.

    abstract::Determine the effectiveness of decontamination, and perform thorough dry or wet decontamination, depending on the circumstances. Always remain cognizant of the fact that, even after decontamination has been completed, contamination may not have been completely eliminated. Perform periodic monitoring to determine wheth...

    journal_title:Critical care (London, England)

    pub_type: 历史文章,杂志文章,评审

    doi:10.1186/cc3062

    authors: Okumura S,Okumura T,Ishimatsu S,Miura K,Maekawa H,Naito T

    更新日期:2005-08-01 00:00:00

  • Propofol: neuroprotection in an in vitro model of traumatic brain injury.

    abstract:INTRODUCTION:The anaesthetic agent propofol (2,6-diisopropylphenol) has been shown to be an effective neuroprotective agent in different in vitro models of brain injury induced by oxygen and glucose deprivation. We examined its neuroprotective properties in an in vitro model of traumatic brain injury. METHODS:In this ...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章

    doi:10.1186/cc7795

    authors: Rossaint J,Rossaint R,Weis J,Fries M,Rex S,Coburn M

    更新日期:2009-01-01 00:00:00

  • Impact of oral care with versus without toothbrushing on the prevention of ventilator-associated pneumonia: a systematic review and meta-analysis of randomized controlled trials.

    abstract:INTRODUCTION:Ventilator-associated pneumonia (VAP) remains a common hazardous complication in mechanically ventilated patients and is associated with increased morbidity and mortality. We undertook a systematic review and meta-analysis of randomized controlled trials to assess the effect of toothbrushing as a component...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,meta分析,评审

    doi:10.1186/cc11675

    authors: Gu WJ,Gong YZ,Pan L,Ni YX,Liu JC

    更新日期:2012-10-12 00:00:00

  • Broadening our perspectives on ICU delirium risk factors.

    abstract::ICU delirium is associated with poor patient outcome. Risk factor stratification is essential to the understanding, prevention and treatment of this disorder. Alcohol consumption, smoking and prior cognitive impairment appear strongly correlated with delirium risk. Several potentially modifiable associations deserve p...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc7917

    authors: Skrobik Y

    更新日期:2009-01-01 00:00:00

  • Multidrug Resistant Gram-Negative Bacteria in Community-Acquired Pneumonia.

    abstract::This article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2019. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2019 . Further information about the Annual Update in Intensive Care and Emergency Medicine is available...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-019-2371-3

    authors: Cillóniz C,Dominedò C,Torres A

    更新日期:2019-03-09 00:00:00

  • Eubaric hyperoxia: controversies in the management of acute traumatic brain injury.

    abstract::Controversy exists on the role of hyperoxia in major trauma with brain injury. Hyperoxia on arterial blood gas has been associated with acute lung injury and pulmonary complications, impacting clinical outcome. The hyperoxia could be reflective of the physiological interventions following major systemic trauma. Despit...

    journal_title:Critical care (London, England)

    pub_type: 评论,杂志文章

    doi:10.1186/cc13065

    authors: Narotam PK

    更新日期:2013-10-16 00:00:00

  • Gut-liver crosstalk in sepsis-induced liver injury.

    abstract::Sepsis is characterized by a dysregulated immune response to infection leading to life-threatening organ dysfunction. Sepsis-induced liver injury is recognized as a powerful independent predictor of mortality in the intensive care unit. During systemic infections, the liver regulates immune defenses via bacterial clea...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,评审

    doi:10.1186/s13054-020-03327-1

    authors: Sun J,Zhang J,Wang X,Ji F,Ronco C,Tian J,Yin Y

    更新日期:2020-10-19 00:00:00

  • Erythropoietin improves long-term neurological outcome in acute ischemic stroke patients: a randomized, prospective, placebo-controlled clinical trial.

    abstract:INTRODUCTION:Mortality and disability following ischemic stroke (IS) remains unacceptably high with respect to the conventional therapies. This study tested the effect of erythropoietin (EPO) on long-term neurological outcome in patients after acute IS. This study aimed to evaluate the safety and efficacy of two consec...

    journal_title:Critical care (London, England)

    pub_type: 杂志文章,随机对照试验

    doi:10.1186/s13054-015-0761-8

    authors: Tsai TH,Lu CH,Wallace CG,Chang WN,Chen SF,Huang CR,Tsai NW,Lan MY,Sung PH,Liu CF,Yip HK

    更新日期:2015-02-25 00:00:00