ArticleIntensive care medicine2018
Second consensus on the assessment of sublingual microcirculation in critically ill patients: results from a task force of the European Society of Intensive Care Medicine.
Article in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 226 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Capillary Refill Time Response to a Rapid Fluid Challenge in Septic Shock Patients: Pathophysiological Determinants, and Relation to Changes in Systemic, Regional and Microcirculatory Blood Flow
The Prognostic Value of Simultaneous Assessment of Microcirculation Alteration With Sublingual Microcirculation and Near-infrared Spectroscopy on the Acute Respiratory Distress Syndrome of Various Phenotypes
Assessment of Microvascular Circulation in the Pediatric Cardiac Surgery Patient
Who cites it
226 citing papers in PubMed, 3 syntheses or guidelines pooled it, 465 citations in OpenAlex.
- ESICM guidelines on circulatory shock and hemodynamic monitoring 2025.Intensive care medicine · 2025Guideline
- Intraoperative haemodynamic monitoring and management of adults having non-cardiac surgery: Guidelines of the German Society of Anaesthesiology and Intensive Care Medicine in collaboration with the German Association of the Scientific Medical Societies.Journal of clinical monitoring and computing · 2024Guideline
- Microcirculatory perfusion disturbances following cardiopulmonary bypass: a systematic review.Critical care (London, England) · 2020Pooled it
- The effect of plasma versus crystalloids on intravascular volume, tissue perfusion and tissue oxygenation: a randomized controlled trial in a human endotoxemia model.Critical care (London, England) · 2026Trial
- Ascorbic acid and microcirculation in cardiothoracic surgery: a pilot feasibility trial and matched cohort study.Journal of cardiothoracic surgery · 2025Trial
- Assisted Fluid Management and Sublingual Microvascular Flow During High-Risk Abdominal Surgery: A Randomized Controlled Trial.Anesthesia and analgesia · 2025Trial
- Intraoperative Dexmedetomidine Enhances Postoperative Microcirculation and Reduces Acute Kidney Injury in Cardiac Surgery: A Double-Blind Randomized Trial.Drug design, development and therapy · 2025Trial
- The Effect of Methylene Blue on Sublingual Microcirculation in Patients with Septic Shock: A Randomized Controlled Trial.Drug design, development and therapy · 2025Trial
- [Relationship between cardiac output, heart rate and microcirculation in patients with multiorgan dysfunction syndrome].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Trial
- Effect of high-dose intravenous ascorbic acid on microcirculation and endothelial glycocalyx during sepsis and septic shock: a double-blind, randomized, placebo-controlled study.BMC anesthesiology · 2023Trial
- Effects of perioperative dexmedetomidine infusion on renal function and microcirculation in kidney transplant recipients: a randomised controlled trial.Annals of medicine · 2022Trial
- Modulation of Endothelial Glycocalyx and Microcirculation in Healthy Young Men during High-Intensity Sprint Interval Cycling-Exercise by Supplementation with Pomegranate Extract. A Randomized Controlled Trial.International journal of environmental research and public health · 2020Trial
- A Data-Efficient Computational Framework for Reconstruction and Simulation of Microcirculatory Perfusion.Microcirculation (New York, N.Y. : 1994) · 2026Article
- Evaluating the endothelial glycocalyx from bench to bedside: a translational framework for microvascular assessment.Angiogenesis · 2026Review
- The OxyCam: A novel hand-held vital microscope for quantitative measurement of microcirculatory perfusion and oxygenation.Journal of intensive medicine · 2026Article
- Physiology, monitoring, and optimisation of perioperative tissue oxygenation: a narrative review.British journal of anaesthesia · 2026Review
- The Geometry of Circulatory Shock: A Conceptual Multi-Scale Lagrangian Framework for Physiology-Informed Hemodynamic Phenotyping.Journal of clinical medicine · 2026Review
- Microcirculatory response and leukocyte activation in patients undergoing elective cardiac surgery with cardiopulmonary bypass.Journal of intensive medicine · 2026Article
- From Glycocalyx Shedding to Microvascular Collapse in Sepsis: Endothelial Pathophysiology, Organ Dysfunction, and Mechanistic Biomarkers.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026Review
- High vasopressor doses are associated with decreased tissue oxygenation in critically ill patients: a secondary analysis of a prospective cohort.Critical care (London, England) · 2026Article
166 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
26 authors at 15 institutions in 11 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeHand-held vital microscopes (HVMs) were introduced to observe sublingual microcirculatory alterations at the bedside in different shock states in critically ill patients. This consensus aims to provide clinicians with guidelines for practical use and interpretation of the sublingual microcirculation. Furthermore, it aims to promote the integration of routine application of HVM microcirculatory monitoring in conventional hemodynamic monitoring of systemic hemodynamic variables.
methodsIn accordance with the Delphi method we organized three international expert meetings to discuss the various aspects of the technology, physiology, measurements, and clinical utility of HVM sublingual microcirculatory monitoring to formulate this consensus document. A task force from the Cardiovascular Dynamics Section of the European Society of Intensive Care Medicine (with endorsement of its Executive Committee) created this consensus as an update of a previous consensus in 2007. We classified consensus statements as definitions, requirements, and/or recommendations, with a minimum requirement of 80% agreement of all participants.
resultsIn this consensus the nature of microcirculatory alterations is described. The nature of variables, which can be extracted from analysis of microcirculatory images, is presented and the needed dataset of variables to identify microcirculatory alterations is defined. Practical aspects of sublingual HVM measurements and the nature of artifacts are described. Eleven statements were formulated that pertained to image acquisitions and quality statements. Fourteen statements addressed the analysis of the images, and 13 statements are related to future developments.
conclusionThis consensus describes 25 statements regarding the acquisition and interpretation of microcirculatory images needed to guide the assessment of the microcirculation in critically ill patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.