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Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Microvascular flow, clinical illness severity and cardiovascular function in the preterm infant
M J Stark1, V L Clifton, I M R Wright
1Mother and Babies Research Centre, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|February 21, 2008
Summary
This study found that microvascular blood flow in preterm infants is linked to illness severity and cardiovascular function shortly after birth. These relationships change over time, highlighting the microvasculature
Area of Science:
- Neonatal physiology
- Cardiovascular adaptation in preterm infants
- Microvascular function
Background:
- Preterm infants experience significant physiological challenges in the immediate newborn period.
- Understanding cardiovascular adaptation is crucial for improving outcomes in premature neonates.
- The role of peripheral microvascular blood flow in this adaptation is not well-characterized.
Purpose of the Study:
- To characterize the relationships between peripheral microvascular blood flow and measures of physiological and cardiovascular function in preterm infants.
- To investigate these relationships in the immediate newborn period (24, 72, and 120 hours of age).
Main Methods:
- Prospective observational cohort study conducted in a tertiary neonatal intensive care unit.
- Included 96 preterm neonates (24-36 weeks' gestation).
- Measured basal microvascular blood flow using laser Doppler, alongside echocardiographic cardiovascular parameters, mean arterial blood pressure, and clinical illness severity (CRIB II score).
Main Results:
- At 24 hours, microvascular blood flow positively correlated with illness severity (CRIB II score) and left ventricular output, but inversely with mean arterial blood pressure.
- A significant inverse relationship between microvascular blood flow and mean arterial blood pressure persisted at 72 hours.
- By 120 hours of age, these significant relationships were no longer evident.
Conclusions:
- This study demonstrates significant relationships between baseline microvascular blood flow, clinical illness severity, and cardiovascular function in preterm infants during the early postnatal period.
- The findings suggest that microvascular function plays a role in cardiovascular adaptation in this vulnerable population.
- Further research is needed to explore the temporal and functional changes in the microvasculature and their impact on cardiovascular adaptation.
