Table 2.
Summary of findings: microcirculatory studies performed in pediatric patients.
| Reference | HVM | Study population | n | Area of interest | Findings |
|---|---|---|---|---|---|
| Top (56) | OPS | Septic shock | 1 | Buccal mucosa | Sepsis therapy recovered macrocirculation, while microcirculation was still compromised |
| Top et al. (8) | OPS | Septic shock: survivors vs. non-survivors | 15/3 | Buccal mucosa | FVD improved on day 2 in survivors, while FVD was lower and did not change in non-survivors; persistent microcirculatory disturbances were prognostic for mortality |
| Top et al. (57) | OPS | Hypoxemic respiratory failure: iNO therapy | 8 | Buccal mucosa | iNO therapy improved FVD |
| Paize et al. (58) | SDF | Meningococcal disease vs. controls | 20/40 | Sublingual mucosa | Microcirculatory parameters were lower in meningococcal disease than in controls but recovered when patients clinically recovered |
| Buijs (59) | SDF | Respiratory failure: VA ECMO vs. VV ECMO | 31/17 | Buccal mucosa | Groups did not differ; PPV and MFI were impaired prior to start ECMO, improved one day after start ECMO and recovered in both groups |
| Buijs et al. (9) | SDF | Post cardiac arrest patients during TH vs. controls | 22/20 | Buccal mucosa | All microcirculatory parameters were impaired during TH; severe impairment at start TH was associated with mortality; microcirculatory parameters improved rapidly after TH |
| Nussbaum et al. (60) | SDF | Diabetes patients vs. controls | 14/14 | Sublingual mucosa | Glycocalyx thickness was reduced in diabetes patients compared to controls and inversely correlated with blood glucose levels; diabetes patients showed more large vessels than small vessels than controls |
| Nussbaum et al. (61) | SDF | Cardiac surgery vs. cardiac catheterization vs. non-cardiac surgery controls | 40/6/9 | Cutaneous (fossa triangularis ear) |
Glycocalyx thickness was reduced after cardiac surgery and returned to baseline values after 1 week; MFI and PVD also declined and returned to baseline values after 24 h |
| Schinagl et al. (62) | SDF | Anemic children receiving RBC transfusion vs. controls | 19/18 | Buccal mucosa | Anemic children showed lower TVD lower and higher RBC velocity than controls; after transfusion, Hb and TVD increased and RBC velocity decreased; TVD and RBC velocity did not reach levels of controls |
| Scolletta et al. (63) | SDF | Cardiac surgery: cyanotic vs. a-cyanotic heart defects | 7/17 | Sublingual mucosa | Microcirculatory parameters did not change over time and were not correlated to macrocirculation in both groups; cyanotic children showed different time trends for PPV and TVD than a-cyanotic children |
| Gonzalez et al. (37) | IDF | Admission pediatric ICU | 105 | Sublingual mucosa | Microcirculatory assessment only possible in 17%, mostly intubated and the more severely ill patients; microcirculatory parameters were moderately correlated with BP, CVP, and lactate |
| Riedijk and Milstein (64) | IDF | Procedural sedation with propofol | 7 | Sublingual mucosa | Propofol induction induced a decline of BP and an increase of TVD and PVD |
BP, blood pressure; CVP, central venous pressure; FVD, functional vascular density; Hb, hemoglobin; HVM, handheld vital microscopy; IDF, incident dark field illumination; iNO, inhaled nitric oxide; MFI, microcirculatory flow index; OPS, orthogonal polarization spectral; PPV, perfused vessel density (%); PVD, perfused vessel density; RBC, red blood cell; SDF, sidestream dark field; TH, therapeutic hypothermia; TVD, total vessel density; VA ECMO, veno-arterial extracorporeal membrane; VV ECMO, veno-venous extracorporeal membrane.