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Evaluation of sublingual microcirculation in children with dengue shock

OBJECTIVE: To report the sublingual microcirculation observed using Sidestream Dark Field imaging in two children with dengue shock. METHOD: Two children, aged 9 and 10 years, were admitted to the pediatric intensive care unit with dengue shock and multiple organ dysfunction. Sublingual microcircula...

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Autores principales: da Luz Caixeta, Daniella Mancino, Fialho, Fernanda Moraes Daniel, Azevedo, Zina Maria Almeida, Collett-Solberg, Paulo Ferrez, Villela, Nivaldo Ribeiro, Bouskela, Eliete
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714847/
https://www.ncbi.nlm.nih.gov/pubmed/23917674
http://dx.doi.org/10.6061/clinics/2013(07)26
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author da Luz Caixeta, Daniella Mancino
Fialho, Fernanda Moraes Daniel
Azevedo, Zina Maria Almeida
Collett-Solberg, Paulo Ferrez
Villela, Nivaldo Ribeiro
Bouskela, Eliete
author_facet da Luz Caixeta, Daniella Mancino
Fialho, Fernanda Moraes Daniel
Azevedo, Zina Maria Almeida
Collett-Solberg, Paulo Ferrez
Villela, Nivaldo Ribeiro
Bouskela, Eliete
author_sort da Luz Caixeta, Daniella Mancino
collection PubMed
description OBJECTIVE: To report the sublingual microcirculation observed using Sidestream Dark Field imaging in two children with dengue shock. METHOD: Two children, aged 9 and 10 years, were admitted to the pediatric intensive care unit with dengue shock and multiple organ dysfunction. Sublingual microcirculation was assessed in each patient on the first and second days of shock and was assessed a final time when the patients were no longer in shock (on the day prior to extubation) using Sidestream Dark Field technology. The De Backer score and microvascular flow index were used for the analyses. RESULTS: Both patients had reduced perfused small vessel density in the first two days and showed predominantly intermittent or no microcirculation flow, as demonstrated by a low microvascular flow index. The blood flow in the large vessels was not affected. Prior to the extubation, the microvascular flow index had increased, although the perfused small vessel density remained diminished, suggesting persistent endothelial dysfunction. CONCLUSIONS: Severe microcirculation changes may be involved in the pathophysiological mechanisms that lead to the final stages of dengue shock, which is frequently irreversible and associated with high mortality rates. Microcirculatory monitoring may help elucidate the physiopathology of dengue shock and prove useful as a prognostic tool or therapeutic target.
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spelling pubmed-37148472013-07-22 Evaluation of sublingual microcirculation in children with dengue shock da Luz Caixeta, Daniella Mancino Fialho, Fernanda Moraes Daniel Azevedo, Zina Maria Almeida Collett-Solberg, Paulo Ferrez Villela, Nivaldo Ribeiro Bouskela, Eliete Clinics (Sao Paulo) Rapid Communication OBJECTIVE: To report the sublingual microcirculation observed using Sidestream Dark Field imaging in two children with dengue shock. METHOD: Two children, aged 9 and 10 years, were admitted to the pediatric intensive care unit with dengue shock and multiple organ dysfunction. Sublingual microcirculation was assessed in each patient on the first and second days of shock and was assessed a final time when the patients were no longer in shock (on the day prior to extubation) using Sidestream Dark Field technology. The De Backer score and microvascular flow index were used for the analyses. RESULTS: Both patients had reduced perfused small vessel density in the first two days and showed predominantly intermittent or no microcirculation flow, as demonstrated by a low microvascular flow index. The blood flow in the large vessels was not affected. Prior to the extubation, the microvascular flow index had increased, although the perfused small vessel density remained diminished, suggesting persistent endothelial dysfunction. CONCLUSIONS: Severe microcirculation changes may be involved in the pathophysiological mechanisms that lead to the final stages of dengue shock, which is frequently irreversible and associated with high mortality rates. Microcirculatory monitoring may help elucidate the physiopathology of dengue shock and prove useful as a prognostic tool or therapeutic target. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo 2013-07 /pmc/articles/PMC3714847/ /pubmed/23917674 http://dx.doi.org/10.6061/clinics/2013(07)26 Text en Copyright © 2013 Hospital das Clínicas da FMUSP http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Rapid Communication
da Luz Caixeta, Daniella Mancino
Fialho, Fernanda Moraes Daniel
Azevedo, Zina Maria Almeida
Collett-Solberg, Paulo Ferrez
Villela, Nivaldo Ribeiro
Bouskela, Eliete
Evaluation of sublingual microcirculation in children with dengue shock
title Evaluation of sublingual microcirculation in children with dengue shock
title_full Evaluation of sublingual microcirculation in children with dengue shock
title_fullStr Evaluation of sublingual microcirculation in children with dengue shock
title_full_unstemmed Evaluation of sublingual microcirculation in children with dengue shock
title_short Evaluation of sublingual microcirculation in children with dengue shock
title_sort evaluation of sublingual microcirculation in children with dengue shock
topic Rapid Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3714847/
https://www.ncbi.nlm.nih.gov/pubmed/23917674
http://dx.doi.org/10.6061/clinics/2013(07)26
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