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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
2013
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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. |
format | Online Article Text |
id | pubmed-3714847 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo |
record_format | MEDLINE/PubMed |
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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