Evaluation of a shorter algorithm in an automated analysis of sublingual microcirculation

Issue title: Selected papers of the 39th Conference of the German Society for Clinical Microcirculation and Hemorheology, 6-7 November 2020, Hannover, Germany

Guest editors: B. Hiebl, A. Krüger-Genge and F. Jung

Article type: Research Article

Authors: Bruno, Raphael Romano^a | Schemmelmann, Mara^a | Wollborn, Jakob^{b; c} | Kelm, Malte^{a; d} | Jung, Christian^{a; *}

Affiliations: [a] Department of Cardiology, Pulmonary Diseases, and Vascular Medicine, Medical Faculty, University Hospital Düsseldorf, Düsseldorf, Germany | [b] Department of Anesthesiology and Critical Care, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany | [c] Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA | [d] Cardiovascular Research Institute Düsseldorf (CARID), Düsseldorf, Germany

Correspondence: [*] Corresponding author: Christian Jung, MD, PhD, University Hospital Düsseldorf, Düsseldorf, Germany. Fax: +49 0 211 81 18812; E-mail: Christian.Jung@med.uni-duesseldorf.de.

Abstract: OBJECTIVE:Diagnostic and risk stratification in intensive and emergency medicine must be fast, accurate, and reliable. The assessment of sublingual microcirculation is a promising tool for this purpose. However, its value is limited because the measurement is time-consuming in unstable patients. This proof-of-concept validation study examines the non-inferiority of a reduced frame rate in image acquisition regarding quality, measurement results, and time. METHODS:This prospective observational study included healthy volunteers. Sublingual measurement of microcirculation was performed using a sidestream dark field camera (SDF, MicroVision Medical®). Video-quality was evaluated with a modified MIQS (microcirculation image quality score). AVA 4.3C software calculated microcirculatory parameters. RESULTS:Thirty-one volunteers were included. There was no impact of the frame rate on the time needed by the software algorithm to measure one video (4.5 ± 0.5 minutes) for AVA 4.3C. 86 frames per video provided non inferior video quality (MIQS 1.8 ± 0.7 for 86 frames versus MIQS 2.2 ± 0.6 for 215 frames, p < 0.05), equal results for all microcirculatory parameters, but did not result in an advantage in terms of speed. No complications occurred. CONCLUSION:Video captures with 86 frames offer equal video quality and results for consensus parameters compared to 215 frames. However, there was no advantage regarding the time needed for the overall measurement procedure.

Keywords: Microcirculation, risk-stratification, SDF-imaging, point-of-care measurement

DOI: 10.3233/CH-209201

Journal: Clinical Hemorheology and Microcirculation, vol. 76, no. 2, pp. 287-297, 2020