Monitoring of the Microcirculation in Cardiac Surgery and Neonates Using Orthogonal Polarization Spectral Imaging

Christ, F.; Genzel‐Boroviczény, Orsolya; Schaudig, Sieglinde; Niklas, M.; Schiessler, C; Strötgen, Julia; Eifert, Sandra; Reichenspurner, H.; Harris, A. G.; Meßmer, K.

doi:10.1159/000061946

Cited by 9 publications

(10 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We found one report on microcirculatory alterations during CPB in neonates where OPS was used, which shows a reduction in vessel density during CPB [18]. …”

Section: Discussionmentioning

confidence: 99%

The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment

Top

Buijs

Schouwenberg

et al. 2012

Critical Care Research and Practice

View full text Add to dashboard Cite

Purpose. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is known to improve cardiorespiratory function and outcome in neonates with severe respiratory failure. We tested the hypothesis that VA-ECMO therapy improves the microcirculation in neonates with severe respiratory failure. Methods. This single-center prospective observational pilot study took place in an intensive care unit of a level III university children's hospital. Twenty-one-term neonates, who received VA-ECMO treatment, were included. The microcirculation was assessed in the buccal mucosa, using Orthogonal Polarization Spectral imaging, within 24 hours before (T1) and within the first 24 hours after initiation of ECMO treatment (T2). Data were compared to data of a ventilated control group (N = 7). Results. At baseline (T1), median functional capillary density (FCD), microvascular flow index (MFI), and heterogeneity index (HI) did not differ between the ECMO group and the control group. At T2 the median FCD was lower in the control group (median [range]: 2.4 [1.4–4.2] versus 4.3 [2.8–7.4] cm/cm2; P value <0.001). For MFI and HI there were no differences at T2 between the two groups. Conclusion. The perfusion of the microcirculation does not change after initiation of VA-ECMO treatment in neonates with severe respiratory failure.

show abstract

“…We found one report on microcirculatory alterations during CPB in neonates where OPS was used, which shows a reduction in vessel density during CPB [18]. …”

Section: Discussionmentioning

confidence: 99%

The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment

Top

Buijs

Schouwenberg

et al. 2012

Critical Care Research and Practice

View full text Add to dashboard Cite

show abstract

“…Their cardiovascular response to hypoperfusion is very restricted because they are limited in heart rate response and their ability to increase myocardial contractility. As this is compensated by a profound vasoconstriction mainly of skin arteriovenous shunts the skin of neonates is somewhat a "shock organ," where distinct vasoconstriction indicates insufficient tissue perfusion (20). Thus, changes in the skin's microcirculation of a preterm newborn associated with infection can be expected.…”

Section: Discussionmentioning

confidence: 99%

Changes in Microcirculation as Early Markers for Infection in Preterm Infants—An Observational Prospective Study

Weidlich

Kroth²,

Nußbaum³

et al. 2009

Pediatr Res

View full text Add to dashboard Cite

ABSTRACT:In adults with severe sepsis, the disturbances of the sublingual microcirculation can be quantified with orthogonal polarization spectral imaging. We investigated the cutaneous microcirculation of preterm infants with proven infection (PosInf) and with suspected but unproven infection (NegInf). In 25 infants, orthogonal polarization spectral images were obtained daily, videos of the images were blinded, and analyzed off-line. Functional small vessel density (FSVD) was prospectively calculated from day 3 to day 30 of life. There were 17 episodes of proven and nine episodes of suspected but unproven nosocomial late onset infection. Four infants remained healthy. The data were analyzed for the 5 d before the start of antibiotics (day Ϫ5 until day Ϫ1). FSVD varied widely, but in the PosInf-group, we found a 10% decline from day Ϫ5 to day Ϫ1 (p ϭ 0.013). There was no significant change over time in the NegInfgroup (p ϭ 0.58). Thus, in infants with proven infection, FSVD decreases already 1 d before changes in laboratory parameters. However, these changes in FSVD during infection are not represented by absolute values, but must be identified by daily intraindividual observation. (Pediatr Res 66: 461-465, 2009) V ery low-birth weight infants are at increased risk for episodes of nosocomial infection, which contributes significantly to mortality and morbidity (1). Early diagnosis and prompt administration of appropriate antibiotics are crucial to improve outcome but clinical signs of infection are very unspecific. White blood cell count has not been shown to improve early diagnosis; C-reactive protein (CRP) is quite specific but not very sensitive for neonatal infection. Cytokines such as interleukine (IL)-6 increase early in neonatal infection before the rise of CRP, and the combination of both increases sensitivity and specificity (2). The need for early treatment in combination with nonspecific clinical signs leads to significant iatrogenic blood loss (3) and an increased exposure to antibiotics.Most clinical signs of infection such as change of skin color, a prolonged capillary filling time, and temperature instability are caused by altered microcirculation. Changes in microcirculation play an important role in the development of septic organ dysfunction (4,5) and the severity of change may even predict outcome (6). Improved technology has made observation and quantification of microcirculatory parameters possible. One of the most promising instrumentation in the regard is the orthogonal polarization spectral (OPS) imaging technique, which allows new insights in the human microcirculation and semiquantified assessment. This method provides high-resolution images of the microvascular architecture to a depth of 1 mm. OPS has been validated by multiple studies in animals and humans (7,8). Using OPS Sakr et al. (6) recently found an association between microcirculatory alterations, organ dysfunction, and death in patients with septic shock. We have previously shown that OPS imaging and measurement of small vess...

show abstract

“…9 The hemoglobin is inhomogeneously distributed in the capillaries and the tissue because of changes in the distribution of the capillary perfusion. 10 The first step of the method is to calculate the product of concentration and path length of the light between the light emitter and the light-receiving fiber. In a second step, the concentration of hemoglobin is calculated.…”

Section: Mathematical Background Of the Methodsmentioning

confidence: 99%

Measurement of Transcutaneous Hemoglobin Concentration by Noninvasive White-Light Spectroscopy in Infants

et al. 2005

View full text Add to dashboard Cite

show abstract

Monitoring of the Microcirculation in Cardiac Surgery and Neonates Using Orthogonal Polarization Spectral Imaging

Cited by 9 publications

References 18 publications

The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment

The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment

Changes in Microcirculation as Early Markers for Infection in Preterm Infants—An Observational Prospective Study

Measurement of Transcutaneous Hemoglobin Concentration by Noninvasive White-Light Spectroscopy in Infants

Contact Info

Product

Resources

About