Table 5.
Pediatric reviews using handheld vital microscopy (HVM) to assess microcirculation.
| Reference | Critical illness | Studies included (n) | Groups (n) | HVM type (n) | Site | Intervention | Outcome |
|---|---|---|---|---|---|---|---|
| Maitoza et al. (64) | SR critical illness | 27 | Studies included: Pediatric 7 Neonate 20 |
OPS 6 SDF 11 IDF LDF 6 NIRS 1 LDPM, CAVM, DRS 2 |
Oral mucosa Forehead Ear conch Cutaneous Buccal mucosa Sublingual |
Critical care support | Critical illness impacts hemodynamic coherence. Microvascular variables do not parallel hemodynamic parameters. |
| Erdem et al. (65) | Review | 34 S | Neonate 22 Pediatric 12 |
OPS 11 SDF 19 IDF 4 |
Cutaneous | Critical care support | HVM is a non-invasive tool capable of monitoring microcirculation. There is a lack of evidence for therapeutic clinical decision-making and its impact on clinical outcomes. |
| Top et al. (66) | Review | 9 S | Neonate 6 Pediatric 3 |
OPS SDF |
Skin Buccal mucosa |
Critical care support | Lack of restoration of deranged MC has a better predictive value for mortality than PRISM. |
| Kuiper et al. (67) | Review | 23 S | Neonate 16 Pediatric 7 |
OPS SDF |
Skin Sublingual Ear |
Critical care support | Describes the use of HVM in pediatric critical care settings, perspectives and research opportunities. |
| Puchwein et al. (68) | Mixed review HVM and biomarkers | 14 S | CHD 6 Trauma (peds) 2 ID and Immune 5 Diabetes 1 |
HVM GlycoCheck Biomarkers |
Serum for biomarker Multiple and PBR (IDF imaging) |
Critical care support | Describes mostly biomarkers used to detect glycocalyx damage with two studies mentioning HVM |
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; CBP, cardiopulmonary bypass; RBC, red blood cell; MCD, meningococcal disease; MC, microcirculation; PRISM, pediatric risk of mortality; LTH, local thermal hyperemia; ROSC, return of spontaneous circulation; CDH, congenital diaphragmatic hernia; MIS-C, multisystem inflammatory syndrome-COVID.