Table 4.
Summary of critically ill neonatal and premature population studies using handheld vital microscopy (HVM).
| Reference | Critical illness | Total patient (n) | Groups (n) | HVM | Site | Intervention | Outcome |
|---|---|---|---|---|---|---|---|
| Alba et al. (53) | Suspected infection | 47 | Newborn: 47 -Infection: 16 -No infection 31 |
OPS | Ear conch Skin/arm |
Infection treated with antibiotic | The proportion of vessels with continuous flow is lower in infants with infection |
| Ergenekon et al. (54) | Polycytemia | 15 | CA, ROSC: 20 Control: 20 |
SDF & NIRS | Skin/arm & head and calf | Partial exchange transfusion | TVD showed no difference after treatment, unlike MFI of small and total vessels, which were higher. Cerebral tissue oxygenation (cTOI) was significantly higher. |
| Top et al. (55) | Persistent Pulmonary Hypertension (PPHN) | 8 | Neonates 6 Pediatric 2 |
OPS | Buccal mucosa | Nitric Oxide use for CDH, Meconium aspiration, bronchiolitis, PARDS | iNO improves the functional capillary density in the microcirculation |
| Ergenekon et al. (56) | Hypoxic ischemic encephalopathy (HIE) | 14 | HIE: 7 Control: 7 |
SDF | Skin/axilla | Therapeutic Hypothermia (TH) | There is a significant decrease in microcirculatory blood flow in patients with hypothermia. |
| Hiedl et al. (57) | Patent Ductus Arteriosus (PDA) | 25 | Preterm <35 weeks GA -PDA 13 -control 12 |
SDF | Skin/axilla | Indomethacin/Ibuprofen | Fewer large vessels and significantly more small vessels in the PDA group. After treatment, these differences disappear. |
| Top et al. (58) | Respiratory failure | 28 | Respiratory failure -ECMO 21 -Ventilated 7 |
OPS | Buccal mucosa | ECMO | ECMO prevents further deterioration of the microcirculation in patients with respiratory failure started on ECMO |
| Buijs et al. (59) | CDH | 56 | CDH: -CDH 28 -Control 28 |
SDF | Buccal mucosa | Catecholamine support | Better microcirculation in the control group. The use of catecholamines does not improve microcirculation in CDH |
| Schwepeke et al. (60) | Hypotension premature <30 weeks BW < 1,225 g | 21 | Hypotensive 10 Control 11 |
SDF | Right arm | Catecholamine support | Patients followed prospectively. FVD was higher in the hypotensive group after birth and recovered 12 h later |
| Fredly et al. (61) | Neonatal asphyxia | 28 | Prospective evaluation | LDPM CAVM DRS | Skin (chest) | Therapeutic Hypothermia (TH) | Day 1 and 3 during hypothermia and day 4 after rewarming. Capillary flow velocity was reduced, and tissue oxygen extraction was higher during TH. |
| Fredly et al. (62) | Neonatal asphyxia and elevated CRP | 28 | Low CRP 18 High CRP 10 |
LDPM CAVM DRS | Skin (chest) | Rewarming after TH | High CRP is associated with higher LDPM perfusion, lower functional vessel density, and larger heterogeneity of capillary flow velocities. |
| Puchwein-Schwepcke et al. (63) | Prematurity and permissive hypercapnia | 12 | High pCO2: 5 Control: 6 |
SDF | Skin (right arm) | Extremely low-birth-weight (ELBW) (<1,000 g) Mechanical ventilation wean | Permissive hypercapnia affects the microcirculation characterized by decreased FVD |
FCD, functional capillary density; MFI, microvascular flow index; CHD, congenital heart disease; SR, systematic review; OPS, orthogonal polarized spectra; SDF, sidestream dark field; IDF, incident dark field; LDF, laser doppler flowmetry; LDPM, laser doppler perfusion measurement; CAVM, computer-assisted video microscopy; DRS, diffuse reflectance spectroscopy; RF, respiratory Failure; CBP, cardiopulmonary bypass; RBC, red blood cell; MCD, meningococcal disease; MC, microcirculation; LTH, local thermal hyperemia; ROSC, return of spontaneous circulation; CDH, congenital diaphragmatic hernia; CRP, C-reactive protein; PBR, perfused boundary region.