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Updated: Mar 17, 2026
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
Microcirculatory changes in children undergoing cardiac surgery: a prospective observational study
S Scolletta1, D Marianello2, G Isgrò3
1Department of Medical Biotechnologies, Anesthesiology and Intensive Care, University Hospital of Siena, Via Bracci 1, Siena 53100, Italy sabino.scolletta@dbm.unisi.it.
Insights
Cardiac surgery alters microcirculation differently in cyanotic vs. acyanotic children. Transfused red blood cell storage time may negatively impact microcirculation in pediatric cardiac surgery patients.
Area of Science:
- Pediatric Cardiology
- Vascular Biology
- Critical Care Medicine
Background:
- The impact of cardiac surgery on the microcirculation of children remains largely unknown.
- Congenital heart disease necessitates surgical correction, often involving complex procedures.
- Understanding microcirculatory changes is crucial for optimizing patient outcomes.
Purpose of the Study:
- To assess microcirculatory alterations in pediatric patients undergoing surgical correction of congenital heart disease.
- To investigate the time-dependent changes in microvascular parameters post-cardiac surgery.
- To explore potential correlations between microcirculatory variables and clinical factors.
Main Methods:
- Utilized Sidestream Dark Field (SDF) videomicroscopy in 24 children under five years old.
- Measured total vascular density (TVD), microvascular flow index (MFI), proportion of perfused small vessels (PPV), and perfused vessel density (PVD) at multiple time points.
- Data collected post-anesthesia, post-surgery, upon ICU admission, and at 6 and 12 hours post-ICU admission.
Main Results:
- Overall microcirculatory variables showed no significant changes over time.
- No significant correlation was observed between hemodynamic parameters and microcirculatory variables.
- Significant interactions between time and cyanosis status were found for PPV, TVD, and PVD in a subanalysis (P=0.03 for all).
- Storage time of transfused red blood cells (RBCs) showed weak inverse correlations with MFI at T3 (r=-0.63, P=0.01) and T4 (r=-0.53, P=0.03).
Conclusions:
- Microcirculatory trends differ between cyanotic and acyanotic children following cardiac surgery.
- The storage duration of transfused RBCs appears to negatively influence microcirculation.
- Further research with larger cohorts is needed to confirm these findings and their clinical implications.
Background:
The effects of cardiac surgery on the microcirculation of children are unknown. The aim of this study was to assess the microcirculatory changes in children undergoing surgery for correction of congenital heart disease.
Methods:
We used a videomicroscope (Sidestream Dark Field, SDF) in a convenience sample of 24 children
Results:
Microcirculatory variables did not significantly change over time. Haemodynamic parameters and microcirculatory variables were not correlated. In a subanalysis conducted for cyanotic (n=7) and acyanotic (n=17) children, repeated measures ANOVA showed a significant interaction between time and the presence of cyanosis for PPV (P=0.03), TVD (P=0.03), and PVD (P=0.03). Weak inverse correlations were found between storage time of transfused red blood cell (RBCs) and MFI at T3 (r=-0.63, P=0.01) and T4 (r=-0.53, P=0.03).
Conclusions:
Microcirculatory variables have a different time-related trend in cyanotic and acyanotic children undergoing cardiac surgery. The storage time of transfused RBCs seems to negatively impact the microcirculation. Further and larger studies are warranted to prove the potential implications of this study.
