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The Point Of CarE Microcirculation (POEM) Assessment Score1

Taking microcirculation monitoring to the bedside

Step 1. For EACH clip, assign a flow assessment:

Normal: Flow mostly normal (< 1/4 of segments have sluggish or stopped flow)

Impaired: Flow is stopped or sluggish in > 1/4 of vessel segments

Critically impaired: Flow is stopped or sluggish in > 1/2 of vessel segments


Step 2. If you have selected “Normal” for a clip, also assign heterogeneity:

Present: > 5 segments have flow that is different from the overall flow

Absent: < 5 segments have flow that is different from the overall flow


Clip 1 Flow
Normal
Impaired
Critically Impaired
Clip 2 Flow
Normal
Impaired
Critically Impaired
Clip 3 Flow
Normal
Impaired
Critically Impaired
Clip 4 Flow
Normal
Impaired
Critically Impaired
POEM Score: None Calculated
Meaning: None Calculated

If the score is not in keeping with global cardiovascular parameters (mean arterial pressure, heart rate, cardiac output) then the patient may have lost haemodynamic coherence2.

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References

  1. Naumann DN, Mellis C, Husheer SLG, Hopkins P, Bishop J, Midwinter MJ, Hutchings SD. Real-time point of care microcirculatory assessment of shock: Design, rationale and application of the Point Of Care Microcirculation (POEM) tool. Critical Care 2016; 20:310. URL: http://ccforum.biomedcentral.com/articles/10.1186/s13054-016-1492-1

  2. Ince C. Hemodynamic coherence and the rationale for monitoring the microcirculation. Crit Care. 2015;19 Suppl 3:S8. URL: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699073/