Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Critical Care
Erschienen in: Critical Care 2/2011

01.04.2011 | Review

The microcirculation of the critically ill pediatric patient

verfasst von: Anke PC Top, Robert C Tasker, Can Ince

Erschienen in: Critical Care | Ausgabe 2/2011

Einloggen, um Zugang zu erhalten

Excerpt

Hemodynamic monitoring is the cornerstone of critical care, especially when the patient is hemodynamically unstable. It needs to be used with the perspective of tailoring treatment to physiology and the underlying disease process [1]. Monitoring should be easy to apply and negative side effects should be limited. The results should be reliable and reproducible, not least because we also need to monitor response to therapy when cardio-vascular insufficiency has been identified. One of the primary goals of hemodynamic monitoring is to alert the physician to impending cardiovascular crisis before organ or tissue injury ensues. …
Literatur
1.
2.
Tibby SM, Hatherill M, Marsh MJ, Murdoch IA: Clinicians' abilities to estimate cardiac index in ventilated children and infants. Arch Dis Child 1997, 77: 516-518. 10.1136/adc.77.6.516PubMedCentralCrossRefPubMed
3.
Egan JR, Festa M, Cole AD, Nunn GR, Gillis J, Winlaw DS: Clinical assessment of cardiac performance in infants and children following cardiac surgery. Intensive Care Med 2005, 31: 568-573. 10.1007/s00134-005-2569-5CrossRefPubMed
4.
Partrick DA, Bensard DD, Janik JS, Karrer FM: Is hypotension a reliable indicator of blood loss from traumatic injury in children? Am J Surg 2002, 184: 555-559. 10.1016/S0002-9610(02)01052-8CrossRefPubMed
5.
Shoemaker WC, Beez M: Pathophysiology, monitoring, and therapy of shock with organ failure. Appl Cardiopulm Pathophysiol 2010, 14: 5-15.
6.
Agata Y, Hiraishi S, Misawa H, et al.: Regional blood flow distribution and left ventricular output during early neonatal life: a quantitative ultrasonographic assessment. Pediatr Res 1994, 36: 805-810. 10.1203/00006450-199412000-00022CrossRefPubMed
7.
Cattermole GN, Leung PY, Mak PS, Chan SS, Graham CA, Rainer TH: The normal ranges of cardiovascular parameters in children measured using the Ultrasonic Cardiac Output Monitor. Crit Care Med 2010, 38: 1875-1881. 10.1097/CCM.0b013e3181e8adeeCrossRefPubMed
8.
Parker MM, Shelhamer JH, Natanson C, Alling DW, Parrillo JE: Serial cardiovascular variables in survivors and nonsurvivors of human septic shock: heart rate as an early predictor of prognosis. Crit Care Med 1987, 15: 923-929. 10.1097/00003246-198710000-00006CrossRefPubMed
9.
Feltes TF, Pignatelli R, Kleinert S, Mariscalco MM: Quantitated left ventricular systolic mechanics in children with septic shock utilizing noninvasive wall-stress analysis. Crit Care Med 1994, 22: 1647-1658.CrossRefPubMed
10.
Ceneviva G, Paschall JA, Maffei F, Carcillo JA: Hemodynamic support in fluid-refractory pediatric septic shock. Pediatrics 1998, 102: e19. 10.1542/peds.102.2.e19CrossRefPubMed
11.
Mercier JC, Beaufils F, Hartmann JF, Azema D: Hemodynamic patterns of meningococcal shock in children. Crit Care Med 1988, 16: 27-33. 10.1097/00003246-198801000-00006CrossRefPubMed
12.
Pollack MM, Fields AI, Ruttimann UE: Distributions of cardiopulmonary variables in pediatric survivors and nonsurvivors of septic shock. Crit Care Med 1985, 13: 454-459. 10.1097/00003246-198506000-00002CrossRefPubMed
13.
Kliegman R: Nelson Textbook of Pediatrics. 18th edition. Philadelphia: Elsevier; 2007.
14.
Tibby SM, Murdoch IA: Measurement of cardiac output and tissue perfusion. Curr Opin Pediatr 2002, 14: 303-309. 10.1097/00008480-200206000-00004CrossRefPubMed
15.
Tibby S: Transpulmonary thermodilution: finally, a gold standard for pediatric cardiac output measurement. Pediatr Crit Care Med 2008, 9: 341-342. 10.1097/PCC.0b013e318172ea56CrossRefPubMed
16.
de Boode WP: Cardiac output monitoring in newborns. Early Hum Dev 2010, 86: 143-148. 10.1016/j.earlhumdev.2010.01.032CrossRefPubMed
17.
Saavedra JM, Harris GD, Li S, Finberg L: Capillary refilling (skin turgor) in the assessment of dehydration. Am J Dis Child 1991, 145: 296-298.PubMed
18.
Mackenzie A, Shann F, Barnes G: Clinical signs of dehydration in children. Lancet 1989, 2: 1529-1530. 10.1016/S0140-6736(89)92979-6CrossRefPubMed
19.
Tibby SM, Hatherill M, Murdoch IA: Capillary refill and core-peripheral temperature gap as indicators of haemodynamic status in paediatric intensive care patients. Arch Dis Child 1999, 80: 163-166. 10.1136/adc.80.2.163PubMedCentralCrossRefPubMed
20.
Levy B: Lactate and shock state: the metabolic view. Curr Opin Crit Care 2006, 12: 315-321. 10.1097/01.ccx.0000235208.77450.15CrossRefPubMed
21.
Fall PJ, Szerlip HM: Lactic acidosis: from sour milk to septic shock. J Intensive Care Med 2005, 20: 255-271. 10.1177/0885066605278644CrossRefPubMed
22.
Hatherill M, Waggie Z, Purves L, Reynolds L, Argent A: Mortality and the nature of metabolic acidosis in children with shock. Intensive Care Med 2003, 29: 286-291. 10.1007/s00134-003-1888-7CrossRefPubMed
23.
Marik PE: Sublingual capnometry: a non-invasive measure of microcirculatory dysfunction and tissue hypoxia. Physiol Meas 2006, 27: R37-R47. 10.1088/0967-3334/27/7/R01CrossRefPubMed
24.
Creteur J, De Backer D, Sakr Y, Koch M, Vincent JL: Sublingual capnometry tracks microcirculatory changes in septic patients. Intensive Care Med 2006, 32: 516-523. 10.1007/s00134-006-0070-4CrossRefPubMed
25.
Fries M, Weil MH, Sun S, et al.: Increases in tissue Pco2 during circulatory shock reflect selective decreases in capillary blood flow. Crit Care Med 2006, 34: 446-452. 10.1097/01.CCM.0000196205.23674.23CrossRefPubMed
26.
Levy B, Gibot S, Franck P, Cravoisy A, Bollaert PE: Relation between muscle Na+K+ ATPase activity and raised lactate concentrations in septic shock: a prospective study. Lancet 2005, 365: 871-875. 10.1016/S0140-6736(05)71045-XCrossRefPubMed
27.
Sakr Y, Dubois MJ, De Backer D, Creteur J, Vincent JL: Persistent microcirculatory alterations are associated with organ failure and death in patients with septic shock. Crit Care Med 2004, 32: 1825-1831. 10.1097/01.CCM.0000138558.16257.3FCrossRefPubMed
28.
Trzeciak S, Rivers EP: Clinical manifestations of disordered microcirculatory perfusion in severe sepsis. Crit Care 2005,9(Suppl 4):S20-S26. 10.1186/cc3744PubMedCentralCrossRefPubMed
29.
30.
Trzeciak S, Dellinger RP, Parrillo JE, et al.: Early microcirculatory perfusion derangements in patients with severe sepsis and septic shock: relationship to hemodynamics, oxygen transport, and survival. Ann Emerg Med 2007, 49: 88-98. 10.1016/j.annemergmed.2006.08.021CrossRefPubMed
31.
Guyton AC, Carrier O, Walker JR: Evidence for Tissue Oxygen Demand as the Major Factor Causing Autoregulation. Circ Res 1964,15(suppl):60-69.PubMed
32.
LeDoux D, Astiz ME, Carpati CM, Rackow EC: Effects of perfusion pressure on tissue perfusion in septic shock. Crit Care Med 2000, 28: 2729-2732. 10.1097/00003246-200008000-00007CrossRefPubMed
33.
Weil MH, Tang W: Welcoming a new era of hemodynamic monitoring: expanding from the macro to the microcirculation. Crit Care Med 2007, 35: 1204-1205. 10.1097/01.CCM.0000259169.33624.D2CrossRefPubMed
34.
Fagrell B, Intaglietta M: Microcirculation: its significance in clinical and molecular medicine. J Intern Med 1997, 241: 349-362. 10.1046/j.1365-2796.1997.125148000.xCrossRefPubMed
35.
Slaaf DW, Tangelder GJ, Reneman RS, Jager K, Bollinger A: A versatile incident illuminator for intravital microscopy. Int J Microcirc Clin Exp 1987, 6: 391-397.PubMed
36.
Groner W, Winkelman JW, Harris AG, et al.: Orthogonal polarization spectral imaging: a new method for study of the microcirculation. Nat Med 1999, 5: 1209-1212. 10.1038/13529CrossRefPubMed
37.
Goedhart PT, Khalilzada M, Bezemer R, Merza J, Ince C: Sidestream Dark Field (SDF) imaging: a novel stroboscopic LED ring-based imaging modality for clinical assessment of the microcirculation. Opt Express 2007, 15: 15101-15114. 10.1364/OE.15.015101CrossRefPubMed
38.
Sherman H, Klausner S, Cook WA: Incident dark-field illumination: a new method for microcirculatory study. Angiology 1971, 22: 295-303. 10.1177/000331977102200507CrossRefPubMed
39.
Balestra GM, Bezemer R, Boerma EC, et al.: Improvement of sidestream dark field imaging with an image acquisition stabilizer. BMC Med Imaging 2010, 10: 15. 10.1186/1471-2342-10-15PubMedCentralCrossRefPubMed
40.
Harris AG, Sinitsina I, Messmer K: Validation of OPS imaging for microvascular measurements during isovolumic hemodilution and low hematocrits. Am J Physiol Heart Circ Physiol 2002, 282: H1502-H1509.CrossRefPubMed
41.
Langer S, Biberthaler P, Harris AG, Steinau HU, Messmer K: In vivo monitoring of microvessels in skin flaps: introduction of a novel technique. Microsurgery 2001, 21: 317-324. 10.1002/micr.1058CrossRefPubMed
42.
Langer S, Born F, Hatz R, Biberthaler P, Messmer K: Orthogonal polarization spectral imaging versus intravital fluorescent microscopy for microvascular studies in wounds. Ann Plastic Surg 2002, 48: 646-653. 10.1097/00000637-200206000-00014CrossRef
43.
Langer S, Harris AG, Biberthaler P, von Dobschuetz E, Messmer K: Orthogonal polarization spectral imaging as a tool for the assessment of hepatic microcirculation: a validation study. Transplantation 2001, 71: 1249-1256. 10.1097/00007890-200105150-00012CrossRefPubMed
44.
Mathura KR, Vollebregt KC, Boer K, De Graaff JC, Ubbink DT, Ince C: Comparison of OPS imaging and conventional capillary microscopy to study the human microcirculation. J Appl Physiol 2001, 91: 74-78.PubMed
45.
De Backer D, Hollenberg S, Boerma C, et al.: How to evaluate the microcirculation: report of a round table conference. Crit Care 2007, 11: R101. 10.1186/cc6118PubMedCentralCrossRefPubMed
46.
Boerma EC, Mathura KR, van der Voort PH, Spronk PE, Ince C: Quantifying bedside-derived imaging of microcirculatory abnormalities in septic patients: a prospective validation study. Crit Care 2005, 9: R601-R606. 10.1186/cc3809PubMedCentralCrossRefPubMed
47.
Dobbe JG, Streekstra GJ, Atasever B, van Zijderveld R, Ince C: Measurement of functional microcirculatory geometry and velocity distributions using automated image analysis. Med Biol Eng Comput 2008, 46: 659-670. 10.1007/s11517-008-0349-4PubMedCentralCrossRefPubMed
48.
De Backer D, Creteur J, Preiser JC, Dubois MJ, Vincent JL: Microvascular blood flow is altered in patients with sepsis. Am J Respir Crit Care Med 2002, 166: 98-104. 10.1164/rccm.200109-016OCCrossRefPubMed
49.
Top AP, van Dijk M, van Velzen JE, Ince C, Tibboel D: Functional capillary density decreases after the first week of life in term neonates. Neonatology 2010, 99: 73-77. 10.1159/000316945CrossRefPubMed
50.
Beinder E, Trojan A, Bucher HU, Huch A, Huch R: Control of skin blood flow in pre- and full-term infants. Biol Neonate 1994, 65: 7-15. 10.1159/000244021CrossRefPubMed
51.
Norman M, Herin P, Fagrell B, Zetterstrom R: Capillary blood cell velocity in full-term infants as determined in skin by videophotometric microscopy. Pediatr Res 1988, 23: 585-588. 10.1203/00006450-198806000-00011CrossRefPubMed
52.
Jahnukainen T, Lindqvist A, Jalonen J, Kero P, Valimaki I: Reactivity of skin blood flow and heart rate to thermal stimulation in infants during the first postnatal days and after a two-month follow-up. Acta Paediatr 1996, 85: 733-738. 10.1111/j.1651-2227.1996.tb14136.xCrossRefPubMed
53.
Genzel-Boroviczeny O, Strotgen J, Harris AG, Messmer K, Christ F: Orthogonal polarization spectral imaging (OPS): a novel method to measure the microcirculation in term and preterm infants transcutaneously. Pediatr Res 2002, 51: 386-391. 10.1203/00006450-200203000-00019CrossRefPubMed
54.
Genzel-Boroviczeny O, Christ F, Glas V: Blood transfusion increases functional capillary density in the skin of anemic preterm infants. Pediatr Res 2004, 56: 751-755. 10.1203/01.PDR.0000141982.38959.10CrossRefPubMed
55.
Kroth J, Weidlich K, Hiedl S, Nussbaum C, Christ F, Genzel-boroviczeny O: Functional vessel density in the first month of life in preterm neonates. Pediatr Res 2008, 64: 567-571. 10.1203/PDR.0b013e318184134eCrossRefPubMed
56.
Hiedl S, Schwepcke A, Weber F, Genzel-Boroviczeny O: Microcirculation in preterm infants: profound effects of patent ductus arteriosus. J Pediatr 2010, 156: 191-196. 10.1016/j.jpeds.2009.08.034CrossRefPubMed
57.
Top AP, Ince C, van Dijk M, Tibboel D: Changes in buccal microcirculation following extracorporeal membrane oxygenation in term neonates with severe respiratory failure. Crit Care Med 2009, 37: 1121-1124. 10.1097/CCM.0b013e3181962a5fCrossRefPubMed
58.
Weidlich K, Kroth J, Nussbaum C, Hiedl S, Bauer A, Christ F, Genzel-Boroviczeny O: Changes in microcirculation as early markers for infection in preterm infants-an observational prospective study. Pediatr Res 2009, 66: 461-465. 10.1203/PDR.0b013e3181b3b1f6CrossRefPubMed
59.
Top AP, Ince C, de Meij N, van Dijk M, Tibboel D: Persistent low microcirculatory vessel density in non-survivors of sepsis in pediatric intensive care. Crit Care Med 2011, 39: 8-13. 10.1097/CCM.0b013e3181fb7994CrossRefPubMed
60.
Top AP, Ince C, Schouwenberg PH, Tibboel D: Inhaled nitric oxide improves systemic microcirculation in infants with hypoxemic respiratory failure. Pediatr Crit Care Med, in press.
61.
Perera P, Kurban K, Ryan TJ: The development of the cutaneous microvascular system in the newborn. Br J Dermatology 1970,82(S5):86-91. 10.1111/j.1365-2133.1970.tb07993.xCrossRef
62.
Stopfkuchen H: Changes of the cardiovascular system during the perinatal period. Eur J Pediatr 1987, 146: 545-549. 10.1007/BF02467350CrossRefPubMed
63.
Trzeciak S, McCoy JV, Dellinger RP, et al.: Early increases in microcirculatory perfusion during protocol-directed resuscitation are associated with reduced multi-organ failure at 24 h in patients with sepsis. Intensive Care Med 2008, 34: 2210-2217. 10.1007/s00134-008-1193-6PubMedCentralCrossRefPubMed
64.
De Backer D, Creteur J, Dubois MJ, Sakr Y, Vincent JL: Microvascular alterations in patients with acute severe heart failure and cardiogenic shock. Am Heart J 2004, 147: 91-99. 10.1016/j.ahj.2003.07.006CrossRefPubMed
65.
Jhanji S, Lee C, Watson D, Hinds C, Pearse RM: Microvascular flow and tissue oxygenation after major abdominal surgery: association with post-operative complications. Intensive Care Med 2009, 35: 671-677. 10.1007/s00134-008-1325-zCrossRefPubMed
Metadaten
Titel
The microcirculation of the critically ill pediatric patient
verfasst von
Anke PC Top
Robert C Tasker
Can Ince
Publikationsdatum
01.04.2011
Verlag
BioMed Central
Erschienen in
Critical Care / Ausgabe 2/2011
Elektronische ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc9995

Weitere Artikel der Ausgabe 2/2011

Critical Care 2/2011 Zur Ausgabe

Research

Activation of factor VII-activating protease in human inflammation: a sensor for cell death

Commentary

Erythropoietin for stroke treatment: dead or alive?

Research

Functional status and quality of life 12 months after discharge from a medical ICU in healthy elderly patients: a prospective observational study

Book report

Luca M. Bigatello (Ed.): Critical Care Handbook of the Massachusetts General Hospital. 5th edition. Philadelphia, PA: Lippincott Williams & Wilkins

Editorial

When pressure does not mean volume? Body mass index may account for the dissociation

Research

Transfusion in trauma: thromboelastometry-guided coagulation factor concentrate-based therapy versus standard fresh frozen plasma-based therapy

Neu im Fachgebiet AINS

23.04.2024 | Appendizitis | Nachrichten

Hinter dieser Appendizitis steckte ein Erreger

23.04.2024 | Leitsymptom Rückenschmerzen | Nachrichten

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 | Operationsvorbereitung | Nachrichten

Mehr Schaden als Nutzen durch präoperatives Aussetzen von GLP-1-Agonisten?

23.04.2024 | Pankreaskarzinom | Nachrichten

S3-Leitlinie zu Pankreaskrebs aktualisiert
weitere anzeigen

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

hier abonnieren