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Hemodynamic coherence and the rationale for monitoring the microcirculation

Overview of attention for article published in Critical Care, December 2015
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (96th percentile)
  • High Attention Score compared to outputs of the same age and source (91st percentile)

Mentioned by

twitter
79 tweeters
facebook
2 Facebook pages

Citations

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281 Dimensions

Readers on

mendeley
282 Mendeley
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Title
Hemodynamic coherence and the rationale for monitoring the microcirculation
Published in
Critical Care, December 2015
DOI 10.1186/cc14726
Pubmed ID
Authors

Can Ince

Abstract

This article presents a personal viewpoint of the shortcoming of conventional hemodynamic resuscitation procedures in achieving organ perfusion and tissue oxygenation following conditions of shock and cardiovascular compromise, and why it is important to monitor the microcirculation in such conditions. The article emphasizes that if resuscitation procedures are based on the correction of systemic variables, there must be coherence between the macrocirculation and microcirculation if systemic hemodynamic-driven resuscitation procedures are to be effective in correcting organ perfusion and oxygenation. However, in conditions of inflammation and infection, which often accompany states of shock, vascular regulation and compensatory mechanisms needed to sustain hemodynamic coherence are lost, and the regional circulation and microcirculation remain in shock. We identify four types of microcirculatory alterations underlying the loss of hemodynamic coherence: type 1, heterogeneous microcirculatory flow; type 2, reduced capillary density induced by hemodilution and anemia; type 3, microcirculatory flow reduction caused by vasoconstriction or tamponade; and type 4, tissue edema. These microcirculatory alterations can be observed at the bedside using direct visualization of the sublingual microcirculation with hand-held vital microscopes. Each of these alterations results in oxygen delivery limitation to the tissue cells despite the presence of normalized systemic hemodynamic variables. Based on these concepts, we propose how to optimize the volume of fluid to maximize the oxygen-carrying capacity of the microcirculation to transport oxygen to the tissues.

Twitter Demographics

The data shown below were collected from the profiles of 79 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 282 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Italy 2 <1%
Canada 1 <1%
Unknown 279 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 40 14%
Other 31 11%
Researcher 28 10%
Student > Postgraduate 28 10%
Student > Ph. D. Student 25 9%
Other 74 26%
Unknown 56 20%
Readers by discipline Count As %
Medicine and Dentistry 173 61%
Nursing and Health Professions 8 3%
Agricultural and Biological Sciences 7 2%
Biochemistry, Genetics and Molecular Biology 6 2%
Engineering 5 2%
Other 19 7%
Unknown 64 23%

Attention Score in Context

This research output has an Altmetric Attention Score of 44. 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 21 June 2022.
All research outputs
#763,398
of 22,067,443 outputs
Outputs from Critical Care
#582
of 5,921 outputs
Outputs of similar age
#16,057
of 406,921 outputs
Outputs of similar age from Critical Care
#42
of 489 outputs
Altmetric has tracked 22,067,443 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 96th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,921 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 18.9. This one has done particularly well, scoring higher than 90% of its peers.
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 406,921 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 489 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 91% of its contemporaries.