The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment

Purpose. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is known to improve cardiorespiratory function and outcome in neonates with severe respiratory failure. We tested the hypothesis that VA-ECMO therapy improves the microcirculation in neonates with severe respiratory failure. Method...

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Main Authors: Anke P. C. Top, Erik A. B. Buijs, Patrick H. M. Schouwenberg, Monique van Dijk, Dick Tibboel, Can Ince
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2012/372956
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author Anke P. C. Top
Erik A. B. Buijs
Patrick H. M. Schouwenberg
Monique van Dijk
Dick Tibboel
Can Ince
author_facet Anke P. C. Top
Erik A. B. Buijs
Patrick H. M. Schouwenberg
Monique van Dijk
Dick Tibboel
Can Ince
author_sort Anke P. C. Top
collection DOAJ
description Purpose. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is known to improve cardiorespiratory function and outcome in neonates with severe respiratory failure. We tested the hypothesis that VA-ECMO therapy improves the microcirculation in neonates with severe respiratory failure. Methods. This single-center prospective observational pilot study took place in an intensive care unit of a level III university children’s hospital. Twenty-one-term neonates, who received VA-ECMO treatment, were included. The microcirculation was assessed in the buccal mucosa, using Orthogonal Polarization Spectral imaging, within 24 hours before (T1) and within the first 24 hours after initiation of ECMO treatment (T2). Data were compared to data of a ventilated control group (𝑁=7). Results. At baseline (T1), median functional capillary density (FCD), microvascular flow index (MFI), and heterogeneity index (HI) did not differ between the ECMO group and the control group. At T2 the median FCD was lower in the control group (median [range]: 2.4 [1.4–4.2] versus 4.3 [2.8–7.4] cm/cm2; P value <0.001). For MFI and HI there were no differences at T2 between the two groups. Conclusion. The perfusion of the microcirculation does not change after initiation of VA-ECMO treatment in neonates with severe respiratory failure.
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spelling doaj-art-2052f51d790f4e43bbfa8511a16b9cc12025-08-20T02:04:48ZengWileyCritical Care Research and Practice2090-13052090-13132012-01-01201210.1155/2012/372956372956The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO TreatmentAnke P. C. Top0Erik A. B. Buijs1Patrick H. M. Schouwenberg2Monique van Dijk3Dick Tibboel4Can Ince5Intensive Care, Erasmus Medical Center-Sophia Children’s Hospital, University Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The NetherlandsIntensive Care, Erasmus Medical Center-Sophia Children’s Hospital, University Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The NetherlandsIntensive Care, Erasmus Medical Center-Sophia Children’s Hospital, University Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The NetherlandsIntensive Care, Erasmus Medical Center-Sophia Children’s Hospital, University Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The NetherlandsIntensive Care, Erasmus Medical Center-Sophia Children’s Hospital, University Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The NetherlandsDepartment of Intensive Care, Erasmus Medical Center, University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The NetherlandsPurpose. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is known to improve cardiorespiratory function and outcome in neonates with severe respiratory failure. We tested the hypothesis that VA-ECMO therapy improves the microcirculation in neonates with severe respiratory failure. Methods. This single-center prospective observational pilot study took place in an intensive care unit of a level III university children’s hospital. Twenty-one-term neonates, who received VA-ECMO treatment, were included. The microcirculation was assessed in the buccal mucosa, using Orthogonal Polarization Spectral imaging, within 24 hours before (T1) and within the first 24 hours after initiation of ECMO treatment (T2). Data were compared to data of a ventilated control group (𝑁=7). Results. At baseline (T1), median functional capillary density (FCD), microvascular flow index (MFI), and heterogeneity index (HI) did not differ between the ECMO group and the control group. At T2 the median FCD was lower in the control group (median [range]: 2.4 [1.4–4.2] versus 4.3 [2.8–7.4] cm/cm2; P value <0.001). For MFI and HI there were no differences at T2 between the two groups. Conclusion. The perfusion of the microcirculation does not change after initiation of VA-ECMO treatment in neonates with severe respiratory failure.http://dx.doi.org/10.1155/2012/372956
spellingShingle Anke P. C. Top
Erik A. B. Buijs
Patrick H. M. Schouwenberg
Monique van Dijk
Dick Tibboel
Can Ince
The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment
Critical Care Research and Practice
title The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment
title_full The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment
title_fullStr The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment
title_full_unstemmed The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment
title_short The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment
title_sort microcirculation is unchanged in neonates with severe respiratory failure after the initiation of ecmo treatment
url http://dx.doi.org/10.1155/2012/372956
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