Changes in buccal microcirculation following extracorporeal membrane oxygenation in term neonates with severe respiratory failure.
OBJECTIVE
Extracorporeal membrane oxygenation (ECMO) is known to improve cardiorespiratory function and outcome in neonates with severe respiratory failure. In this study, we tested two hypotheses: 1) neonates with severe respiratory failure exhibit alterations of the microcirculation and 2) after ECMO therapy these microcirculatory alterations are improved.


METHODS
Single-center prospective observational study.


METHODS
Intensive care unit of a level III university children's hospital.


METHODS
Term neonates receiving venoarterial ECMO. Control patients with and without respiratory failure.


RESULTS
The microcirculation was assessed in the buccal mucosa, using orthogonal polarization spectral imaging, before and after ECMO. Functional capillary density was lower in patients with severe respiratory failure before ECMO (n = 14) compared with control patients (n = 10; p < 0.01). Functional capillary density had increased significantly after ECMO (p < 0.01).


CONCLUSIONS
Microcirculatory parameters are depressed in neonates with severe respiratory failure and improve significantly following ECMO treatment.
Top
Anke P C
AP
Department of Intensive Care, Erasmus Medical Center-Sophia Children's hospital, Rotterdam, The Netherlands. p.top@erasmusmc.nl
Ince
Can
C
van Dijk
Monique
M
Tibboel
Dick
D
D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008833:Microcirculation; D009055:Mouth / Q000098:blood supply*; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000503:physiopathology* / Q000628:therapy*; D012720:Severity of Illness Index; D047929:Term Birth