Capillary Blood Cell Velocity in Full-Term Infants as Determined in Skin by Videophotometric Microscopy

Norman, Mikael; Herin, Peter; Fagrell, B; Zetterström, Rolf

doi:10.1203/00006450-198806000-00011

Cited by 31 publications

(16 citation statements)

References 9 publications

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“…Our data are in accordance with capillary diameters measured with nailfold capillaroscopy, where values between 6 and 15 m were found (6). A 0.4 -0.5-m thick endothelial surface coat reduces functional capillary volume.…”

Section: Discussionsupporting

confidence: 80%

“…Capillary blood cell velocity increased in a strong nonlinear relationship, with a reduction in hematocrit as a result of an exchange transfusion (210 m/s; healthy controls 300 m/s) (16). RBC velocity as reported by us and by Norman et al (6) does not significantly differ from the values found in nailfold low capillary blood cell velocity of healthy adults (100 -500 m/s). The total neonatal peripheral blood flow has been found to be twice as high in adults (20).…”

Section: Discussionsupporting

confidence: 59%

“…Under no stress conditions the skin has high blood flow in relation to its oxygen requirement. Assessment of skin perfusion is therefore of great interest, but there is only very scant data about the microcirculatory perfusion in the skin of term neonates and no data for preterm infants (5,6). Density of perfused skin vessels has never been measured in neonates in vivo.…”

mentioning

confidence: 99%

“…Current methods for clinical investigation of the cutaneous microcirculation in patients are based on laser Doppler flowmetry and capillary videomicroscopy. Capillary videomicroscopy in the neonate so far has been limited to the vascular bed of the nailfold in term infants (6). Direct observation of vascular beds of other organs in humans has been difficult or even impossible because of the need for tissue transillumination and fluorescent dyes for contrast enhancement, or by the size of instruments required to obtain images.…”

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confidence: 99%

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Orthogonal Polarization Spectral Imaging (OPS): A Novel Method to Measure the Microcirculation in Term and Preterm Infants Transcutaneously

et al. 2002

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Little is known about the microvascular perfusion of the skin postnatally. Skin microvascular parameters can be assessed noninvasively with orthogonal polarization spectral imaging (OPS), a technique where, through the use of special optics, a virtual light source is created at a depth of 1 mm within the tissue. The light is absorbed by the Hb, yielding an image of the illuminated Hb-carrying structures in negative contrast. In nine term (weight 2100 -4470 g) and 28 preterm infants (weight 550 -2070 g; gestational age 24 -33 wk) red blood cell velocity and vessel diameter and density were determined off-line with the CapImage program in vessels video-recorded by OPS near the axilla on d 1 and 5 of life. Blood pressure, heart rate, hematocrit, and body and incubator temperature were noted. Vessel diameter ranged from 6 to 24 m, vessel density from 219 to 340 cm/cm 2 with no change between d 1 or 5 and no difference between term and preterm infants. Red blood cell velocity increased in preterm infants from d 1 [median 528 m/s, 95% confidence interval (CI) 486 -564 m/s] to d 5 (median 570 m/s; 95% CI 548 -662 m/s; p ϭ 0.001) and correlated with the decrease in median hematocrit from 44% (CI 40%-60%) to 39% (CI 37%-43%) with r 2 ϭ Ϫ0.37 with a 95% CI Ϫ0.59 to Ϫ0.11, p ϭ 0.006. Hematocrit correlates with red blood cell velocity in the microvessels of the skin. The new technology can be used to assess quantitative changes in the microvessels and thus allows noninvasive assessment of tissue perfusion in term and preterm infants. At birth, the skin is richly supplied by a dense subepidermal plexus that shows relatively little regional variation. Even the middle and deep dermis are richly endowed with vasculature. The mature pattern of capillary loops and of the subpapillary venous plexus is not present at birth. With exception of the palms, soles, and nail beds, the skin at birth has almost no papillary loops, but demonstrates a disorderly capillary network. By the end of the first week of life, the capillary network assumes a more orderly pattern. Papillary loops begin to appear as small superficial dilatations or buds in the second week and cooling of the skin appears to encourage maturation. The skin architecture in newborns is notably different from those of an adult. Whereas the latter regularly shows loops of capillaries running orthogonal to the surface of the skin, the neonate has a more horizontal structure, which is readily seen through the very thin upper layers (1-4).Cardiac output normalized to mass is much higher in the newborn than in the adult. Because of the high resting cardiac output of neonates there is limited reserve to further augment blood flow under stress. Perfusion pressure is maintained by redistributing marginal cardiac output and oxygen supply to brain, heart, and adrenal gland. Under no stress conditions the skin has high blood flow in relation to its oxygen requirement. Assessment of skin perfusion is therefore of great interest, but there is only very scant data about the microcirculator...

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 59%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Orthogonal Polarization Spectral Imaging (OPS): A Novel Method to Measure the Microcirculation in Term and Preterm Infants Transcutaneously

et al. 2002

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“…Little is known about the microcirculation in children and infants. A few studies in newborns and infants have used videophotometric microscopy or laser Doppler to evaluate blood cell velocity in the nailfold capillaries of the thumb [5,6] . More recently, the group of Genzel-Boroviczeny applied OPS imaging in premature and term infants to study the microvascular perfusion of the skin [7,8] .…”

Section: Introductionmentioning

confidence: 99%

Functional Capillary Density Decreases after the First Week of Life in Term Neonates

et al. 2010

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Background: Changes in the microcirculation have been recognized to play a crucial role in many disease processes. In premature neonates, functional capillary density (FCD) decreases during the first months of life. Objectives: The aims of this study were to obtain microcirculatory parameters in term neonates and older children who did not present with compromised respiration or circulation and to determine developmental changes in the microcirculation in young children. Methods: This single-center prospective observational study was performed at a level III university children’s hospital. Subjects eligible for inclusion were children up to the age of 3 years who did not have any respiratory compromise, circulatory compromise or signs of dehydration. The buccal mucosa of 45 children was assessed, using orthogonal polarization spectral imaging. Results: We found a significantly higher FCD in neonates younger than 1 week compared with older children. The median FCD was 8.1 cm/cm² (range 7.3–9.4) for 0- to 7-day-old neonates (n = 12), 6.9 cm/cm² (range 4.7–8.7) for 8- to 28-day-olds (n = 10), 7.3 cm/cm² (range 6.1–8.8) for 1- to 6-month-olds (n = 19) and 6.7 cm/cm² (range 6.5–9.2) for 3-year-olds (n = 4). After the first week, there was no significant correlation between age and FCD. Conclusion: FCD of the buccal mucosa decreases after the first week of life.

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Vascular Tumors (Hemangiomas) in Childhood

Cremer¹

2000

Textbook of Angiology

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Capillary Blood Cell Velocity in Full-Term Infants as Determined in Skin by Videophotometric Microscopy

Cited by 31 publications

References 9 publications

Orthogonal Polarization Spectral Imaging (OPS): A Novel Method to Measure the Microcirculation in Term and Preterm Infants Transcutaneously

Orthogonal Polarization Spectral Imaging (OPS): A Novel Method to Measure the Microcirculation in Term and Preterm Infants Transcutaneously

Functional Capillary Density Decreases after the First Week of Life in Term Neonates

Vascular Tumors (Hemangiomas) in Childhood

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