Cytocam-IDF (incident dark field illumination) imaging for bedside monitoring of the microcirculation

Abstract

BackgroundOrthogonal polarized spectral (OPS) and sidestream dark field (SDF) imaging video microscope devices were introduced for observation of the microcirculation but, due to technical limitations, have remained as research tools. Recently, a novel handheld microscope based on incident dark field illumination (IDF) has been introduced for clinical use. The Cytocam-IDF imaging device consists of a pen-like probe incorporating IDF illumination with a set of high-resolution lenses projecting images on to a computer controlled image sensor synchronized with very short pulsed illumination light. This study was performed to validate Cytocam-IDF imaging by comparison to SDF imaging in volunteers.MethodsThis study is a prospective, observational study. The subjects consist of 25 volunteers.ResultsSublingual microcirculation was evaluated using both techniques. The main result was that Cytocam-IDF imaging provided better quality images and was able to detect 30% more capillaries than SDF imaging (total vessels density Cytocam-IDF: 21.60 ± 4.30 mm/mm2 vs SDF: 16.35 ± 2.78 mm/mm2, p < 0.0001). Comparison of the images showed increased contrast, sharpness, and image quality of both venules and capillaries.ConclusionsCytocam-IDF imaging detected more capillaries and provided better image quality than SDF imaging. It is concluded that Cytocam-IDF imaging may provide a new improved imaging modality for clinical assessment of microcirculatory alterations.Electronic supplementary materialThe online version of this article (doi:10.1186/s40635-015-0040-7) contains supplementary material, which is available to authorized users.

Intraoperative Incident Dark Field Imaging of the Human Peritoneal Microcirculation

“…This might lead to redistributed flow in the microcirculation. However, since our results regarding quantitative parameters of the sublingual microcirculation are in agreement with previous studies [19, 20, 25, 28], it seems that these differences cannot be attributed to the time point at which the measurements were performed.…”

“…This technique has been described extensively elsewhere [25, 27]. In summary, the CytoCam uses green light (530 nm) produced from a ring of light-emitting diodes arranged near the tip of the probe.…”

“…The camera is connected to a device controller based on a powerful medical grade computer. Video clips are directly saved as digital AVI-DV files to a hard drive [25]. …”

“…The current study aimed to use the CytoCam [25], a recently introduced third-generation handheld microscope based on incident dark field (IDF) imaging, for visualization and assessment of the human peritoneal microcirculation. Measurements were performed during hepatic surgery in patients in which the peritoneum was not affected by pathology.…”

Macro-hemodynamic targets and hemostatic effects of fluid resuscitation during experimental hemorrhagic shock

“…However, despite the almost immediate correction of cardiac output and arterial pressure, the sublingual microcirculation took up to 4 days to recover, with the length of time to recover correlating with the occurrence of organ dysfunction [60]. With the introduction of a new generation of hand-held microscopy at the bedside, the nature of microcirculatory alterations has been elucidated and it opens the way to enabling titration of fluids to optimally recruit the microcirculation in such a way as to optimize its oxygen transport capacity [61].…”