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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 (95th percentile)
  • High Attention Score compared to outputs of the same age and source (91st percentile)

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80 X users
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2 Facebook pages

Citations

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397 Dimensions

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349 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.

X Demographics

X Demographics

The data shown below were collected from the profiles of 80 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 349 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 346 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 42 12%
Other 39 11%
Researcher 32 9%
Student > Ph. D. Student 32 9%
Student > Postgraduate 30 9%
Other 91 26%
Unknown 83 24%
Readers by discipline Count As %
Medicine and Dentistry 201 58%
Nursing and Health Professions 11 3%
Biochemistry, Genetics and Molecular Biology 8 2%
Agricultural and Biological Sciences 7 2%
Engineering 6 2%
Other 23 7%
Unknown 93 27%
Attention Score in Context

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 14 November 2023.
All research outputs
#976,927
of 26,132,653 outputs
Outputs from Critical Care
#726
of 6,678 outputs
Outputs of similar age
#16,014
of 397,430 outputs
Outputs of similar age from Critical Care
#42
of 483 outputs
Altmetric has tracked 26,132,653 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 6,678 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 20.7. This one has done well, scoring higher than 89% 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 397,430 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 95% of its contemporaries.
We're also able to compare this research output to 483 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.