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

Top, Anke P. C.; Dijk, Monique van; Velzen, J.E. van; İnce, Can; Tibboel, Dick

doi:10.1159/000316945

Cited by 37 publications

(47 citation statements)

References 33 publications

(26 reference statements)

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“…15 An extensive capillary network in the newborn's skin forms in the first weeks after birth first in a disorderly manner, and then, between 14 and 17 weeks after birth, the length and variability of the diameter of the capillaries increase. 16,17 This is consistent with the recent report by Top et al, 18 who examined the capillary microcirculation in the buccal mucosa in term neonates at 0 to 7 days, 8 to 28 days, 1 to 6 months, and at 3 years using orthogonal polarized spectroscopy imaging and found higher basal capillary density in infants Ͻ1 week old compared with older children, confirming that basal capillary density decreases progressively after the first week of life. 18 This group did not study maximal capillary density given that they studied the buccal mucosa, and maximization would not have been possible.…”

Section: Discussionsupporting

confidence: 88%

“…16,17 This is consistent with the recent report by Top et al, 18 who examined the capillary microcirculation in the buccal mucosa in term neonates at 0 to 7 days, 8 to 28 days, 1 to 6 months, and at 3 years using orthogonal polarized spectroscopy imaging and found higher basal capillary density in infants Ͻ1 week old compared with older children, confirming that basal capillary density decreases progressively after the first week of life. 18 This group did not study maximal capillary density given that they studied the buccal mucosa, and maximization would not have been possible. In LBW infants, the higher capillary density could be a compensatory response to improve tissue perfusion and nutrient delivery to counter the effects of the "insult" that caused the intrauterine growth restriction in the first place.…”

Section: Discussionsupporting

confidence: 88%

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Low Birth Weight Infants Do Not Have Capillary Rarefaction at Birth

et al. 2011

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Abstract-Low birth weight predicts adult essential hypertension and is linked to increased cardiovascular mortality in adult life. A reduction in capillary density (ie, rarefaction) is a hallmark of essential hypertension, and evidence suggests that rarefaction precedes the onset of the rise in blood pressure, because it is found in normotensive individuals at high risk of developing hypertension, suggesting that rarefaction is likely to be a primary structural abnormality. We hypothesized that low birth weight infants would have significant capillary rarefaction at birth. We studied 44 low birth weight infants born to normotensive mothers (33 were born preterm, birth weight: 1823Ϯ446 g; and 11 were born at term, birth weight: 2339Ϯ177 g) and compared them with 71 infants born at term with normal weight (birth weight: 3333Ϯ519 g). We used orthogonal polarized spectroscopy to measure basal (ie, functional) and maximal (ie, structural) skin capillary densities. Low birth weight infants, whether born preterm or at term, had significantly higher functional capillary density (mean difference of 10.5 capillaries per millimeter squared; 95% CI: 6.6 -14.4 capillaries per millimeter squared; PϽ0.0001) and higher structural capillary density (mean difference of 11.1 capillaries per millimeter squared; 95% CI: 7.6 -14.5 capillaries per millimeter squared; PϽ0.0001) when compared with normal weight term infants. We conclude that low birth weight infants born to normotensive mothers do not have capillary rarefaction at birth. These results contradict what might have been predicted from the concept of the intrauterine origins of adult disease and suggest that microcirculatory abnormalities observed in individuals of low birth weight occur in postnatal life rather than during their intrauterine existence. (Hypertension. 2011;58:847-851.)Key Words: capillary rarefaction Ⅲ microcirculation Ⅲ hypertension Ⅲ low birth weight M icrocirculatory abnormalities and impaired tissue perfusion have been implicated in the pathogenesis of essential hypertension, obesity, diabetes mellitus, and insulin resistance. 1 In essential hypertension in particular, a reduction in the spatial density of arterioles and capillaries (ie, rarefaction) appears to play a central role. 2 We have shown previously that much of the capillary rarefaction in essential hypertension is attributed to the structural (ie, anatomic) absence of capillaries. 3 We have also shown significant capillary rarefaction in patients with borderline intermittent essential hypertension and in normotensive offspring of hypertensive parents, suggesting a familial predisposition in which capillary rarefaction represents a primary vascular abnormality that antedates the onset of sustained elevation of blood pressure (BP). 4,5 There is now a strong body of evidence showing that low birth weight (LBW), that is, birth weight of Ͻ2.5 kg regardless of gestation or causation, 6 is associated with structural and functional vascular abnormalities, 7 the development of essential hypertension, 8...

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 88%

Low Birth Weight Infants Do Not Have Capillary Rarefaction at Birth

et al. 2011

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“…In the last few years, several studies have focused on peripheral circulation [10][11][12][13] . Evaluating peripheral tissue blood flows is important for the early recognition and treatment of cardiovascular changes.…”

Section: Changes In Skin Andmentioning

confidence: 99%

Changes in Skin and Subcutaneous Perfusion in Very-Low-Birth-Weight Infants during the Transitional Period

Ishiguro¹,

Sekine²,

Suzuki³

et al. 2011

Neonatology

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Background: Conventional parameters of circulation that are routinely used in neonatal intensive care units, including blood pressure, have been reported to be inadequate in improving prognosis of very-low-birth-weight (VLBW) infants. Recently, the importance of evaluating the blood flow to each organ, including both vital and nonvital organs, has been increasingly recognized. Objectives: To study the changes in peripheral perfusion occurring in VLBW infants of less than 32 weeks’ gestation during the extrauterine transitional period. Methods: In 32 VLBW infants of less than 32 weeks’ gestation, forehead blood flow (FBF) and lower-limb blood flow (LBF) were measured for 48 h after birth using a novel laser Doppler flowmeter, and the indices of vascular resistance were estimated. Superior vena cava (SVC) blood flow was measured by echocardiography. Changes in these variables of circulation as well as the correlations were evaluated. Results: Both FBF and LBF significantly increased at 24 h, while the SVC flow remained unchanged over the same period. Both forehead and lower-limb vascular resistance indices significantly decreased at 24 h. LBF was negatively and positively correlated with estimated upper body vascular resistance and SVC flow, respectively. Conclusions: The increase in the peripheral blood flow along with the decrease in the peripheral vascular resistance indices, without an increase in the systemic blood flow at 24 h of age, indicated vasodilation in skin and subcutaneous tissue during the transitional period in VLBW infants. FBF and LBF can be useful parameters as indicators of both peripheral and systemic circulation.

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“…Estos cambios precoces parecen tener relación con la adaptación post natal más que con la edad post-concepción 23 . El modelo "tipo adulto" de microcirculación a nivel cutáneo es alcanzado a los tres meses de edad 24 .…”

Section: Cambios Post Natalesunclassified

La microcirculación en el paciente crítico: Parte I: generalidades y fisiología en el paciente séptico

et al. 2013

Rev. chil. pediatr.

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ARTÍCULO DE REVISIÓNREVIEW ARTICLE Rev Chil Pediatr 2013; 84 (1): 83-92 La microcirculación en el paciente crítico. ABSTRACT Microcirculation in the critically ill. Part I: Review and physiology of septic patientsSevere sepsis and septic shock involve circulatory, inflammatory and metabolic disorders eventually resulting in a disruption of cellular energy. Microcirculatory disturbances are common in septic patients. Microcirculation is the primary site of oxygen and nutrients exchange to cells. Direct observation using Sidestream Dark Field (SDF) imaging has allowed direct visualization of microcirculatory failure in critically ill patients. Septic shock is characterized by weak or vulnerable microcirculatory units and heterogeneity of microcirculatory flow. Multiple mechanisms may contribute to these alterations, including endothelial dysfunction, altered glycocalyx, impaired inter-cell communication and adhesion and rolling of white blood cells and platelets. Many therapeutic interventions routinely used in the treatment of critically ill patients seem to result in limited changes in microcirculatory perfusion, irrespective of systemic hemodynamics, due to the heterogeneous nature of these changes and the potentially involved mechanisms. Therefore, microcirculatory alterations and their presence in states of shock, especially in septic shock, can represent diagnostic and severity stratification tools and may be a target for therapeutic intervention (microcirculatory resuscitation), besides suggesting a prognostic role.

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

Cited by 37 publications

References 33 publications

Low Birth Weight Infants Do Not Have Capillary Rarefaction at Birth

Low Birth Weight Infants Do Not Have Capillary Rarefaction at Birth

Changes in Skin and Subcutaneous Perfusion in Very-Low-Birth-Weight Infants during the Transitional Period

La microcirculación en el paciente crítico: Parte I: generalidades y fisiología en el paciente séptico

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