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Monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: A pilot study

BACKGROUND: Monitoring of the macrocirculation during surgery provides limited information on the quality of organ perfusion. OBJECTIVE: We investigated the feasibility of perioperative microcirculatory measurements in children. METHODS: Sublingual microvessels were visualized by handheld videomicro...

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Autores principales: Wagner, Marie, Anzinger, Eveline, Hey, Florian, Reiter, Karl, Wermelt, Julius Z., Pastor-Villaescusa, Belén, Genzel-Boroviczény, Orsolya, Nussbaum, Claudia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116146/
https://www.ncbi.nlm.nih.gov/pubmed/36502307
http://dx.doi.org/10.3233/CH-221617
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author Wagner, Marie
Anzinger, Eveline
Hey, Florian
Reiter, Karl
Wermelt, Julius Z.
Pastor-Villaescusa, Belén
Genzel-Boroviczény, Orsolya
Nussbaum, Claudia
author_facet Wagner, Marie
Anzinger, Eveline
Hey, Florian
Reiter, Karl
Wermelt, Julius Z.
Pastor-Villaescusa, Belén
Genzel-Boroviczény, Orsolya
Nussbaum, Claudia
author_sort Wagner, Marie
collection PubMed
description BACKGROUND: Monitoring of the macrocirculation during surgery provides limited information on the quality of organ perfusion. OBJECTIVE: We investigated the feasibility of perioperative microcirculatory measurements in children. METHODS: Sublingual microvessels were visualized by handheld videomicroscopy in 11 children (19 mo – 10 yrs) undergoing surgery > 120 min at four time points: T0) after induction of anesthesia; T1) before end of anesthesia, T2) 6 h post surgery and T3) 24 h post surgery. RESULTS: Measurements were feasible in all children at T0 and T1. At T2 and T3, imaging was restricted to 6 and 4 infants, respectively, due to respiratory compromise and missing cooperation. The capillary density was reduced at T1 compared to T0 (8.1 mm/mm(2) [4.0-17.0] vs. 10.6 mm/mm(2) [5.1-19.3]; p = 0.01), and inversely related to norepinephrine dose (Pearson r = -0.65; p = 0.04). Microvascular flow and serum glycocalyx makers Syndecan-1 and Hyaluronan increased significantly from T0 to T1. CONCLUSION: Perioperative microcirculatory monitoring in children requires a high amount of personal and logistic resources still limiting its routine use. Major surgery is associated with microvascular alterations and glycocalyx perturbation. The possible consequences on patient outcome need further evaluation. Efforts should concentrate on the development of next generation devices designed to facilitate microcirculatory monitoring in children.
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spelling pubmed-101161462023-04-21 Monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: A pilot study Wagner, Marie Anzinger, Eveline Hey, Florian Reiter, Karl Wermelt, Julius Z. Pastor-Villaescusa, Belén Genzel-Boroviczény, Orsolya Nussbaum, Claudia Clin Hemorheol Microcirc Research Article BACKGROUND: Monitoring of the macrocirculation during surgery provides limited information on the quality of organ perfusion. OBJECTIVE: We investigated the feasibility of perioperative microcirculatory measurements in children. METHODS: Sublingual microvessels were visualized by handheld videomicroscopy in 11 children (19 mo – 10 yrs) undergoing surgery > 120 min at four time points: T0) after induction of anesthesia; T1) before end of anesthesia, T2) 6 h post surgery and T3) 24 h post surgery. RESULTS: Measurements were feasible in all children at T0 and T1. At T2 and T3, imaging was restricted to 6 and 4 infants, respectively, due to respiratory compromise and missing cooperation. The capillary density was reduced at T1 compared to T0 (8.1 mm/mm(2) [4.0-17.0] vs. 10.6 mm/mm(2) [5.1-19.3]; p = 0.01), and inversely related to norepinephrine dose (Pearson r = -0.65; p = 0.04). Microvascular flow and serum glycocalyx makers Syndecan-1 and Hyaluronan increased significantly from T0 to T1. CONCLUSION: Perioperative microcirculatory monitoring in children requires a high amount of personal and logistic resources still limiting its routine use. Major surgery is associated with microvascular alterations and glycocalyx perturbation. The possible consequences on patient outcome need further evaluation. Efforts should concentrate on the development of next generation devices designed to facilitate microcirculatory monitoring in children. IOS Press 2023-04-07 /pmc/articles/PMC10116146/ /pubmed/36502307 http://dx.doi.org/10.3233/CH-221617 Text en © 2023 – The authors. Published by IOS Press https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Wagner, Marie
Anzinger, Eveline
Hey, Florian
Reiter, Karl
Wermelt, Julius Z.
Pastor-Villaescusa, Belén
Genzel-Boroviczény, Orsolya
Nussbaum, Claudia
Monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: A pilot study
title Monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: A pilot study
title_full Monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: A pilot study
title_fullStr Monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: A pilot study
title_full_unstemmed Monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: A pilot study
title_short Monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: A pilot study
title_sort monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: a pilot study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116146/
https://www.ncbi.nlm.nih.gov/pubmed/36502307
http://dx.doi.org/10.3233/CH-221617
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