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MicroDAIMON study: Microcirculatory DAIly MONitoring in critically ill patients: a prospective observational study

Overview of attention for article published in Annals of Intensive Care, May 2018
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2 tweeters

Citations

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27 Dimensions

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34 Mendeley
Title
MicroDAIMON study: Microcirculatory DAIly MONitoring in critically ill patients: a prospective observational study
Published in
Annals of Intensive Care, May 2018
DOI 10.1186/s13613-018-0411-9
Pubmed ID
Authors

Claudia Scorcella, Elisa Damiani, Roberta Domizi, Silvia Pierantozzi, Stefania Tondi, Andrea Carsetti, Silvia Ciucani, Valentina Monaldi, Mara Rogani, Benedetto Marini, Erica Adrario, Rocco Romano, Can Ince, E. Christiaan Boerma, Abele Donati

Abstract

Until now, the prognostic value of microcirculatory alterations in critically ill patients has been mainly evaluated in highly selected subgroups. Aim of this study is to monitor the microcirculation daily in mixed group of Intensive Care Unit (ICU)-patients and to establish the association between (the evolution of) microcirculatory alterations and outcome. This is a prospective longitudinal observational single-centre study in adult patients admitted to a 12-bed ICU in an Italian teaching hospital. Sublingual microcirculation was evaluated daily, from admission to discharge/death, using Sidestream Dark Field imaging. Videos were analysed offline to assess flow and density variables. Laboratory and clinical data were recorded simultaneously. A priori, a Microvascular Flow Index (MFI) < 2.6 was defined as abnormal. A binary logistic regression analysis was performed to evaluate the association between microcirculatory variables and outcomes; a Kaplan-Meier survival curve was built. Outcomes were ICU and 90-day mortality. A total of 97 patients were included. An abnormal MFI was present on day 1 in 20.6%, and in 55.7% of cases during ICU admission. Patients with a baseline MFI < 2.6 had higher ICU, in-hospital and 90-day mortality (45 vs. 15.6%, p = 0.012; 55 vs. 28.6%, p = 0.035; 55 vs. 26%, p = 0.017, respectively). An independent association between baseline MFI < 2.6 and outcome was confirmed in a binary logistic analysis (odds ratio 4.594 [1.340-15.754], p = 0.015). A heart rate (HR) ≥ 90 bpm was an adjunctive predictor of mortality. However, a model with stepwise inclusion of mean arterial pressure < 65 mmHg, HR ≥ 90 bpm, lactate > 2 mmol/L and MFI < 2.6 did not detect significant differences in ICU mortality. In case an abnormal MFI was present on day 1, ICU mortality was significantly higher in comparison with patients with an abnormal MFI after day 1 (38 vs. 6%, p = 0.001), indicating a time-dependent significant difference in prognostic value. In a general ICU population, an abnormal microcirculation at baseline is an independent predictor for mortality. In this setting, additional routine daily microcirculatory monitoring did not reveal extra prognostic information. Further research is needed to integrate microcirculatory monitoring in a set of commonly available hemodynamic variables. Trial registration NCT 02649088, www.clinicaltrials.gov . Date of registration: 23 December 2015, retrospectively registered.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 34 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 34 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 5 15%
Researcher 4 12%
Other 4 12%
Student > Doctoral Student 3 9%
Lecturer 2 6%
Other 7 21%
Unknown 9 26%
Readers by discipline Count As %
Medicine and Dentistry 14 41%
Biochemistry, Genetics and Molecular Biology 2 6%
Engineering 2 6%
Sports and Recreations 1 3%
Agricultural and Biological Sciences 1 3%
Other 5 15%
Unknown 9 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 17 May 2018.
All research outputs
#9,662,627
of 15,184,575 outputs
Outputs from Annals of Intensive Care
#491
of 672 outputs
Outputs of similar age
#165,831
of 277,099 outputs
Outputs of similar age from Annals of Intensive Care
#2
of 2 outputs
Altmetric has tracked 15,184,575 research outputs across all sources so far. This one is in the 23rd percentile – i.e., 23% of other outputs scored the same or lower than it.
So far Altmetric has tracked 672 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.4. This one is in the 19th percentile – i.e., 19% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 277,099 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 2 others from the same source and published within six weeks on either side of this one.