Videomicroscopy as a tool for investigation of the microcirculation in the newborn.
The perinatal period remains a time of significant risk of death or disability. Increasing evidence suggests that this depends on microcirculatory behavior. Sidestream dark-field orthogonal polarized light videomicroscopy (OPS) has emerged as a useful assessment of adult microcirculation but the values derived are not delineated for the newborn. We aimed to define these parameters in well term newborn infants. Demographic details were collected prospectively on 42 healthy term neonates (n = 20 females, n = 22 males). OPS videomicroscopy (Microscan) was used to view ear conch skin microcirculation at 6, 24, and 72 h of age. Stored video was analyzed by a masked observer using proprietary software. There were no significant differences between the sexes for any structural parameters at any time point. There was a significant increase over time in small vessel perfusion in female infants only (P = 0.009). A number of 6- and 72-h measurements were significantly correlated, but differed from the 24-h values. These observations confirm the utility of the ear conch for neonatal microvascular videomicroscopy. They provide a baseline for studies into the use of OPS videomicroscopy in infants. The changes observed are comparable with previous studies of term infants using these and other microvascular techniques. It is recommended that studies for examining the mature neonatal microvascular structure be delayed until 72 h of life, but studies of the physiology of cardiovascular transition should include the 24-h time point after delivery.
Hunter Medical Research Institute, Newcastle, New South Wales, Australia Discipline of Paediatrics and Child Health, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia Kaleidoscope Neonatal Intensive Care Unit, John Hunter Children's Hospital, Newcastle, New South Wales, Australia Graduate School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia iwright@uow.edu.au.
Ian M R
IM
Wright
Hunter Medical Research Institute, Newcastle, New South Wales, Australia Discipline of Paediatrics and Child Health, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
Joanna L
JL
Latter
Hunter Medical Research Institute, Newcastle, New South Wales, Australia Discipline of Paediatrics and Child Health, School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia Graduate School of Medicine and Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.
Rebecca M
RM
Dyson
Hunter Medical Research Institute, Newcastle, New South Wales, Australia.
Chris R
CR
Levi
Mater Medical Research Institute, University of Queensland, Brisbane, Queensland, Australia.
Vicki L
VL
Clifton
D001724:Birth Weight; D001783:Blood Flow Velocity / Q000502:physiology; D002196:Capillaries / Q000000981:diagnostic imaging*; D002320:Cardiovascular Physiological Phenomena; D004425:Ear Cartilage / Q000098:blood supply* / Q000000981:diagnostic imaging; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D018715:Microscopy, Video / Q000379:methods*; D011247:Pregnancy; D011446:Prospective Studies; D012039:Regional Blood Flow; D012867:Skin / Q000098:blood supply* / Q000000981:diagnostic imaging
Capillary; cardiovascular; microcirculation; newborn; videomicroscopy
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