Videocapillaroscopy of the oral mucosa as an non-invasive tool for early detection of sepsis
Introduction. Due to the high incidence, morbidity, mortality and high costs for the health system, sepsis stands out, among other things, by the firm indication of hospitalization in an intensive care unit. Dysfunction of microcirculation plays a central role in the genesis and maintenance of septi...
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| Format: | Article |
| Language: | English |
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Amaltea Medical Publishing House
2022-03-01
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| Series: | Romanian Medical Journal |
| Subjects: | |
| Online Access: | https://rmj.com.ro/articles/2022.1/RMJ_2022_1_Art-04.pdf |
| _version_ | 1797332882053660672 |
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| author | Gabriel Petre Gorecki Cosmin Moldovan Elena Rusu Daniel Cochior |
| author_facet | Gabriel Petre Gorecki Cosmin Moldovan Elena Rusu Daniel Cochior |
| author_sort | Gabriel Petre Gorecki |
| collection | DOAJ |
| description | Introduction. Due to the high incidence, morbidity, mortality and high costs for the health system, sepsis stands out, among other things, by the firm indication of hospitalization in an intensive care unit. Dysfunction of microcirculation plays a central role in the genesis and maintenance of septic syndrome, as it represents a pathophysiological milestone of this syndrome. Videocapillaroscopy opens up the possibility of detecting microvascular anomalies in the early stages, allowing for new diagnostic and research opportunities.
Material and method. Our unrandomized, prospective, multicenter, analytical study analysed a group of 51 patients with various ethology of septic shock, a clinical condition that was diagnosed on the basis of standard clinical and biological criteria, hospitalized in three ICU clinical wards, over the course of 15 months (August 2019 - November 2020), where the parameters of the oral mucosa microcirculation were monitored with the help of a videocapillaroscope, the resulting prototype of an invention patent already implemented by the authors.
Objectives. The main objective of our study was to validate, on a clinical level, the possibility of using videocapillaroscopy of the oral mucosa, as an efficient means of early detection of the changes that predict the early onset of septic shock in patients in ICU patients.
Results. Videocapillaroscopy was performed with a prototype device, recording 357 images of the microcirculation of the oral mucosa in the patients that had already been confirmed, via classical clinical and paraclinical means, with the diagnosis of sepsis. Discussions. The statistical analysis of the essential 5 elements detected by videocapillaroscopy (capillary density, incidence in normal and parallel disposition, diameter and microhemorrhage) corroborated with the clinical and paraclinical elements of the sepsis state path clearly highlights the correlation power of these determinations.
Conclusions. Given the completely non-invasive nature of this imaging method, the very low costs associated with the method, the ease in collecting and interpreting data as well as the results that bear strong statistical correlation, we can conclude that it can successfully be considered a method of prediction with high reliability and specificity in the early detection of sepsis, regardless of its etiology. |
| first_indexed | 2024-03-08T07:55:47Z |
| format | Article |
| id | doaj.art-6adc9427f19247b78a7f6913ae0bb47f |
| institution | Directory Open Access Journal |
| issn | 1220-5478 2069-606X |
| language | English |
| last_indexed | 2024-03-08T07:55:47Z |
| publishDate | 2022-03-01 |
| publisher | Amaltea Medical Publishing House |
| record_format | Article |
| series | Romanian Medical Journal |
| spelling | doaj.art-6adc9427f19247b78a7f6913ae0bb47f2024-02-02T13:49:38ZengAmaltea Medical Publishing HouseRomanian Medical Journal1220-54782069-606X2022-03-01691172310.37897/RMJ.2022.1.4Videocapillaroscopy of the oral mucosa as an non-invasive tool for early detection of sepsisGabriel Petre Gorecki0Cosmin Moldovan1Elena Rusu2Daniel Cochior3Doctoral School of Medicine, IOSUD Titu Maiorescu University of Bucharest, Romania; Bucur Maternity Hospital, "Sf. Ioan" Emergency Hospital, Bucharest, RomaniaFaculty of Medicine, Titu Maiorescu University of Bucharest, Romania; General Surgery Clinic, CF1 Witting Clinical Hospital, Bucharest, RomaniaFaculty of Medicine, Titu Maiorescu University of Bucharest, Romania Faculty of Medicine, Titu Maiorescu University of Bucharest, Romania; General Surgery Clinic, Monza Clinical Hospital, Bucharest, Romania; Sanador Clinical Hospital, Bucharest, RomaniaIntroduction. Due to the high incidence, morbidity, mortality and high costs for the health system, sepsis stands out, among other things, by the firm indication of hospitalization in an intensive care unit. Dysfunction of microcirculation plays a central role in the genesis and maintenance of septic syndrome, as it represents a pathophysiological milestone of this syndrome. Videocapillaroscopy opens up the possibility of detecting microvascular anomalies in the early stages, allowing for new diagnostic and research opportunities. Material and method. Our unrandomized, prospective, multicenter, analytical study analysed a group of 51 patients with various ethology of septic shock, a clinical condition that was diagnosed on the basis of standard clinical and biological criteria, hospitalized in three ICU clinical wards, over the course of 15 months (August 2019 - November 2020), where the parameters of the oral mucosa microcirculation were monitored with the help of a videocapillaroscope, the resulting prototype of an invention patent already implemented by the authors. Objectives. The main objective of our study was to validate, on a clinical level, the possibility of using videocapillaroscopy of the oral mucosa, as an efficient means of early detection of the changes that predict the early onset of septic shock in patients in ICU patients. Results. Videocapillaroscopy was performed with a prototype device, recording 357 images of the microcirculation of the oral mucosa in the patients that had already been confirmed, via classical clinical and paraclinical means, with the diagnosis of sepsis. Discussions. The statistical analysis of the essential 5 elements detected by videocapillaroscopy (capillary density, incidence in normal and parallel disposition, diameter and microhemorrhage) corroborated with the clinical and paraclinical elements of the sepsis state path clearly highlights the correlation power of these determinations. Conclusions. Given the completely non-invasive nature of this imaging method, the very low costs associated with the method, the ease in collecting and interpreting data as well as the results that bear strong statistical correlation, we can conclude that it can successfully be considered a method of prediction with high reliability and specificity in the early detection of sepsis, regardless of its etiology.https://rmj.com.ro/articles/2022.1/RMJ_2022_1_Art-04.pdfsepsisseptic shockearly detectionvideocapillaroscopemucosaoral |
| spellingShingle | Gabriel Petre Gorecki Cosmin Moldovan Elena Rusu Daniel Cochior Videocapillaroscopy of the oral mucosa as an non-invasive tool for early detection of sepsis Romanian Medical Journal sepsis septic shock early detection videocapillaroscope mucosa oral |
| title | Videocapillaroscopy of the oral mucosa as an non-invasive tool for early detection of sepsis |
| title_full | Videocapillaroscopy of the oral mucosa as an non-invasive tool for early detection of sepsis |
| title_fullStr | Videocapillaroscopy of the oral mucosa as an non-invasive tool for early detection of sepsis |
| title_full_unstemmed | Videocapillaroscopy of the oral mucosa as an non-invasive tool for early detection of sepsis |
| title_short | Videocapillaroscopy of the oral mucosa as an non-invasive tool for early detection of sepsis |
| title_sort | videocapillaroscopy of the oral mucosa as an non invasive tool for early detection of sepsis |
| topic | sepsis septic shock early detection videocapillaroscope mucosa oral |
| url | https://rmj.com.ro/articles/2022.1/RMJ_2022_1_Art-04.pdf |
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