title: Peripheral blood flow monitoring in an infant with septic shock.
abstract: Septic shock is associated with impaired vasoregulation, and treatment includes vasoactive drugs. Therefore, evaluation of vasoregulatory change is important. The present report describes the successful characterization of vasoregulatory change in response to a vasoactive drug during septic shock. A male infant born at 23 weeks' gestation developed septic shock. Severe hypotension developed, and treatment with colloid fluid and dopamine failed to increase blood pressure. With continuous measurement of skin blood flow using laser Doppler, noradrenaline was started. Based on changes in the blood flow, the dose was increased. At a dose of 1 μg/kg per min, skin blood flow in the foot decreased without any change in blood pressure. Subsequent blood transfusion succeeded in increasing both blood pressure and skin blood flow. It is concluded that decrease in foot blood flow reflects the vasoconstrictive effect of noradrenaline, although this finding must be validated in larger studies.
authors.affiliation: Department of Pediatrics, Division of Neonatal Medicine, Center for Maternal, Fetal and Neonatal Medicine, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Ishiguro
authors.forename: Sayaka
authors.initials: S
authors.lastname: Sakazaki
authors.forename: Ryuta
authors.initials: R
authors.lastname: Itakura
authors.forename: Sumie
authors.initials: S
authors.lastname: Fujinuma
authors.forename: Shuntaro
authors.initials: S
authors.lastname: Oka
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Motojima
authors.forename: Hisanori
authors.initials: H
authors.lastname: Sobajima
authors.forename: Masanori
authors.initials: M
authors.lastname: Tamura
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012039:Regional Blood Flow; D012772:Shock, Septic / Q000503:physiopathology*; D012867:Skin / Q000098:blood supply
keywords: laser Doppler flowmetry; microcirculation; regional blood flow; sepsis; septic shock