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Bedside hyperspectral imaging for the evaluation of microcirculatory alterations in perioperative intensive care medicine: a study protocol for an observational clinical pilot study (HySpI-ICU)
  1. Maximilian Dietrich1,
  2. Sebastian Marx1,
  3. Thomas Bruckner2,
  4. Felix Nickel3,
  5. Beat Peter Müller-Stich3,
  6. Thilo Hackert3,
  7. Markus A Weigand1,
  8. Florian Uhle1,
  9. Thorsten Brenner1,4,
  10. Karsten Schmidt1,4
  1. 1Department of Anaesthesiology, University Hospital Heidelberg, Heidelberg, Germany
  2. 2Institute of Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany
  3. 3Department of General, Visceral and Transplantation Surgery, University Hospital Heidelberg, Heidelberg, Germany
  4. 4Department of Anesthesiology and Intensive Care Medicine, University Hospital Essen, University Duisburg-Essen, Essen, North Rhine-Westphalia, Germany
  1. Correspondence to Dr Karsten Schmidt;{at}


Introduction Normalisation of macrocirculatory parameters during resuscitation therapy does not guarantee the restoration of microcirculatory perfusion in critical illness due to haemodynamic incoherence. Persistent microcirculatory abnormalities are associated with severity of organ dysfunction and mandate the development of bedside microcirculatory monitoring. A novel hyperspectral imaging (HSI) system can visualise changes in skin perfusion, oxygenation and water content at the bedside. We aim to evaluate the effectiveness of HSI for bedside monitoring of skin microcirculation and the association of HSI parameters with organ dysfunction in patients with sepsis and major abdominal surgery.

Methods and analysis Three independent groups will be assessed and separately analysed within a clinical prospective observational study: (1) 25 patients with sepsis or septic shock (according to sepsis-3 criteria), (2) 25 patients undergoing pancreatic surgery and (3) 25 healthy controls. Patients with sepsis and patients undergoing pancreatic surgery will receive standard therapy according to local protocols derived from international guidelines. In addition, cardiac output of perioperative patients and patients with sepsis will be measured. Healthy controls undergo one standardised evaluation. The TIVITA Tissue System is a novel HSI system that uses the visible and near-infrared spectral light region to determine tissue microcirculatory parameters. HSI analysis (hand/knee) will be done in parallel to haemodynamic monitoring within defined intervals during a 72-hour observation period. HSI data will be correlated with the Sequential Organ Failure Assessment score, global haemodynamics, inflammation and glycocalyx markers, surgical complications and 30-day outcome.

Ethics and dissemination The protocol has been approved by the local ethics committee of the University of Heidelberg (S-148/2019). Study results will be submitted to peer-reviewed journals and medical conferences.

Trial registration number DRKS00017313; Pre-results.

  • adult intensive & critical care
  • adult anaesthesia
  • intensive & critical care
  • anaesthetics

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors MD, FU, TBre, MAW and KS contributed to the conception of the study. MD, SM, FU, TBre, MAW and KS contributed to the design of the study. MD, FU, TBru and KS planned the statistical analysis. MD and KS wrote the first draft of the protocol. SM, TBru, FN, BPM-S, TH, MAW, FU and TBre critically revised the protocol for important intellectual content. All authors approved the final manuscript to be published.

  • Funding The Diaspective Vision GmbH supported the research project through providing a TIVITA Tissue System. We acknowledge support by the Open Access Publication Fund of the University of Duisburg-Essen.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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