Peripheral circulation in the newborn: Interaction of peripheral blood flow, blood pressure, blood volume, and blood viscosity

Linderkamp, Otwin; Strohhacker, I.; Versmold, Hans T.; Klose, Holger; Riegel, K; Betke, Klaus

doi:10.1007/bf00442366

Cited by 36 publications

(9 citation statements)

References 35 publications

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“…The results of the present study and previously reported results are shown in Table 2 (13)(14)(15)(16)(17). Our data are similar to the previously reported data.…”

Section: Discussionsupporting

confidence: 92%

Estimation of circulating blood volume in infants using the pulse dye densitometry method

Nagano¹,

Kusaka

Okubo³

et al. 2005

Pediatric Anesthesia

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“…The results of the present study and previously reported results are shown in Table 2 (13)(14)(15)(16)(17). Our data are similar to the previously reported data.…”

Section: Discussionsupporting

confidence: 92%

Estimation of circulating blood volume in infants using the pulse dye densitometry method

Nagano¹,

Kusaka

Okubo³

et al. 2005

Pediatric Anesthesia

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“…In addition, RBC vel inversely correlated with mean systolic blood pressure. This seems surprising since past studies have shown that blood pressure in premature infants correlates with blood flow (35). In those studies, blood flow was measured with venous occlusion plethysmography, which will determine arterial blood flow in vessels of all sizes.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, our values probably are a mixture of venous and arterial flow velocities. Previous studies have shown that resistance and viscosity play a crucial role in neonatal peripheral blood flow (35,36). Both undergo marked changes in the first days of life.…”

Section: Discussionmentioning

confidence: 99%

“…This method allows the assessment of the quality of tissue perfusion for the skin. We know blood pressure homeostasis is superior to maintenance of peripheral perfusion in the newborn period, since this patient population respond to acute hypovolemia with marked decrease in peripheral flow and an increase in peripheral resistance and only small changes in blood pressure (35). Thus, the measurements of the microcirculation of the skin might be an easily accessible window to obtain better understanding of circulatory changes in infants in the postnatal period.…”

Section: Discussionmentioning

confidence: 99%

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Functional Vessel Density in the First Month of Life in Preterm Neonates

Kroth¹,

Weidlich

Hiedl³

et al. 2008

Pediatr Res

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Changes in microcirculation have been recognized as central to many disease processes. The aim of this study was to evaluate factors, which influence the microcirculation of the skin during the first month of life in premature infants. Red blood cell (RBC) velocity, vessel diameter, and functional small vessel density (FSVD) were measured daily for the first 30 d on the upper arm in preterm infants with gestational age Ͻ30 wk. Orthogonal polarization spectral (OPS) images were analyzed off-line with the CapiScope-Image program. In 25 infants, FSVD decreased significantly from week 1 (mean Ϯ SD 236 Ϯ 33 cm/cm 2 ) to week 4 (207 Ϯ 30 cm/cm 2 ) and correlated directly with Hb levels and incubator temperature. Vessel diameters and RBC velocity did not change significantly, nor did clinical parameters such as blood pressure, heart rate or body temperature. Microvascular parameters were not dependent on gestational or postnatal age. The microcirculation of the skin might be an easily accessible window to obtain better understanding of circulatory changes in the postnatal period. Our data are essential as basis for further studies in this field. Hb levels and possible incubator temperatures have a substantial influence on functional small vessel density and therefore need to be taken in account. D isturbances of the microcirculation play a key role in many disease states (1-4). The recent development of new technologies has helped to investigate these changes in adult patients with sepsis (5-7). Previous studies have shown that parameters of microcirculation such as microvessel diameter, red blood cell velocity, and functional small vessel density (FSVD) can be measured in the skin of term and preterm infants by Orthogonal Polarization Spectral (OPS) imaging in the first week of life (8) and that FSVD increases after elective blood transfusion in anemic neonates (9). The microcirculation of the skin plays an important role in maintaining a constant body temperature and in regulating the fluid balance (10,11). Adequate function of the microcirculation is a prerequisite for tissue nutrition and oxygen supply (12). The microcirculation of the skin in neonates differs in several aspects from that of an adult. The regular architecture has been found to be poorly developed in the newborn (13). At birth, the skin shows a disorderly capillary network and no papillary loops in almost all areas, except the palms, soles, and nail folds. The skin is richly supplied by a dense subepidermal plexus demonstrating relatively little regional variation (14).Functional capillary density (FCD) is one of the parameters that delineate the microcirculation. FCD is defined as the length of red cell-perfused capillaries per observation area and is given as cm/cm 2 . FCD has been used as an indicator of the quality of tissue perfusion (15). In neonates capillary vessels, arterioles, and venules cannot clearly be differentiated in the OPS images, so that the expression FSVD is used.The aim of the study was to determine whether tissue pe...

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“…Deficiency of red cell mass causes impairment of oxygen transport to the tissues during the entire progress of the respiratory disease: A low red cell mass reflects a low blood volume at the time of cord-clamping [28,32]. Hypovolaemia, probably one major side effect of intra-partum asphyxia, causes marked reduction of cardiac output [26] and of peripheral blood flow [18,35] in the newborn. Hypoxia may further reduce cardiac output [26] and disturb the microcirculation [20], and this is probably mediated by catecholamines [21].…”

Section: Discussionmentioning

confidence: 99%

Association of neonatal respiratory distress with birth asphyxia and deficiency of red cell mass in premature infants

et al. 1978

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Red cell mass (RCM) was estimated using 125I-labelled human serum albumin in 128 premature infants born after 26 to 36 weeks gestation. Infants of three different gestational periods (26--29, 30--32, and 33--36 weeks) with respiratory distress (RD) averaged lower one-minute Apgar scores and lower RCM than infants without RD (P less than 0.05). The incidence of RD was significantly (P less than 0.05) higher in infants with Apgar scores below 6 and in infants with RCM of less than 35 ml/kg than in the infants with greater values. The highest incidence of RD and the highest mortality rate were found in the infants with low Apgar scores and low RCM values. Prematures with similar Apgar scores showed a higher incidence of RD when RCM was low, and infants with similar RCM showed a higher incidence of RD when Apgar scores were low. Our results suggest that both birth asphyxia and deficiency of red cell mass interfere with postnatal cardio-respiratory adaptation. In high-risk premature infants, erythrocytes should be transfused when the venous haematocrit is below 0.459

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Peripheral circulation in the newborn: Interaction of peripheral blood flow, blood pressure, blood volume, and blood viscosity

Cited by 36 publications

References 35 publications

Estimation of circulating blood volume in infants using the pulse dye densitometry method

Estimation of circulating blood volume in infants using the pulse dye densitometry method

Functional Vessel Density in the First Month of Life in Preterm Neonates

Association of neonatal respiratory distress with birth asphyxia and deficiency of red cell mass in premature infants

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