OPS Imaging of Human Microcirculation: A Short Technical Report

Lindert, Jens; Werner, J; Redlin, Matthias; Kuppe, Hermann; Habazettl, Helmut; Pries, Axel R.

doi:10.1159/000065549

Cited by 81 publications

(52 citation statements)

References 10 publications

(11 reference statements)

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“…The existing appliances, e.g., working with vacuum are hardly practicable in premature infants as the skin is too sensible and space in incubator is very restricted (21). If the probe is placed at the skin with uncontrolled high pressure, microvessels are compressed, and the blood flow is inhibited or even stagnates/ stops.…”

Section: Discussionmentioning

confidence: 99%

Changes in Microcirculation as Early Markers for Infection in Preterm Infants—An Observational Prospective Study

Weidlich

Kroth²,

Nußbaum³

et al. 2009

Pediatr Res

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ABSTRACT:In adults with severe sepsis, the disturbances of the sublingual microcirculation can be quantified with orthogonal polarization spectral imaging. We investigated the cutaneous microcirculation of preterm infants with proven infection (PosInf) and with suspected but unproven infection (NegInf). In 25 infants, orthogonal polarization spectral images were obtained daily, videos of the images were blinded, and analyzed off-line. Functional small vessel density (FSVD) was prospectively calculated from day 3 to day 30 of life. There were 17 episodes of proven and nine episodes of suspected but unproven nosocomial late onset infection. Four infants remained healthy. The data were analyzed for the 5 d before the start of antibiotics (day Ϫ5 until day Ϫ1). FSVD varied widely, but in the PosInf-group, we found a 10% decline from day Ϫ5 to day Ϫ1 (p ϭ 0.013). There was no significant change over time in the NegInfgroup (p ϭ 0.58). Thus, in infants with proven infection, FSVD decreases already 1 d before changes in laboratory parameters. However, these changes in FSVD during infection are not represented by absolute values, but must be identified by daily intraindividual observation. (Pediatr Res 66: 461-465, 2009) V ery low-birth weight infants are at increased risk for episodes of nosocomial infection, which contributes significantly to mortality and morbidity (1). Early diagnosis and prompt administration of appropriate antibiotics are crucial to improve outcome but clinical signs of infection are very unspecific. White blood cell count has not been shown to improve early diagnosis; C-reactive protein (CRP) is quite specific but not very sensitive for neonatal infection. Cytokines such as interleukine (IL)-6 increase early in neonatal infection before the rise of CRP, and the combination of both increases sensitivity and specificity (2). The need for early treatment in combination with nonspecific clinical signs leads to significant iatrogenic blood loss (3) and an increased exposure to antibiotics.Most clinical signs of infection such as change of skin color, a prolonged capillary filling time, and temperature instability are caused by altered microcirculation. Changes in microcirculation play an important role in the development of septic organ dysfunction (4,5) and the severity of change may even predict outcome (6). Improved technology has made observation and quantification of microcirculatory parameters possible. One of the most promising instrumentation in the regard is the orthogonal polarization spectral (OPS) imaging technique, which allows new insights in the human microcirculation and semiquantified assessment. This method provides high-resolution images of the microvascular architecture to a depth of 1 mm. OPS has been validated by multiple studies in animals and humans (7,8). Using OPS Sakr et al. (6) recently found an association between microcirculatory alterations, organ dysfunction, and death in patients with septic shock. We have previously shown that OPS imaging and measurement of small vess...

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Section: Discussionmentioning

confidence: 99%

Changes in Microcirculation as Early Markers for Infection in Preterm Infants—An Observational Prospective Study

Weidlich

Kroth²,

Nußbaum³

et al. 2009

Pediatr Res

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“…The techniques including both capillaroscopy and OPS imaging used in our study were validated for measuring skin capillary density. 2,11,14 Although capillaroscopy is of limited use in people with thick and dark skin, this technique issue will not affect the changes in capillary density during the randomized crossover period, because the same measurement methods were used throughout the whole study, and participants served as their own control in the crossover trial. The question is whether there is a difference between ethnic groups in capillary density and microvascular response to salt reduction; our study was not designed to address these questions.…”

Section: He Et Al Effect Of Salt Reduction On Capillary Rarefactionmentioning

confidence: 99%

“…Orthogonal polarization spectral (OPS) imaging is a relatively new technique that allows direct visualization of the microcirculation in various human tissues and has the advantage of providing high contrast images as it uses the absorption of hemoglobin to visualize the microcirculation with a polarized light technique. [12][13][14] Furthermore, the degree of magnification with OPS technique is approximately double that achieved by standard capillaroscopy.…”

mentioning

confidence: 95%

Effect of Modest Salt Reduction on Skin Capillary Rarefaction in White, Black, and Asian Individuals With Mild Hypertension

Marciniak

Markandu

et al. 2010

Hypertension

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Abstract-Microvascular rarefaction occurs in hypertension. We carried out a 12-week randomized double-blind crossover trial to determine the effect of a modest reduction in salt intake on capillary rarefaction in 71 whites, 69 blacks, and 29 Asians with untreated mildly raised blood pressure. Both basal and maximal (during venous congestion) skin capillary density were measured by capillaroscopy at the dorsum and the side of the fingers. In addition, we used orthogonal polarization spectral imaging to measure skin capillary density at the dorsum of the fingers and the hand web. With a reduction in salt intake from 9.7 to 6.5 g/day, there was an increase in capillary density (capillaries per millimeter squared) from 101Ϯ21 to 106Ϯ23 (basal) and 108Ϯ22 to 115Ϯ22 (maximal) at the dorsum, and 101Ϯ25 to 107Ϯ26 (basal) and 110Ϯ26 to 116Ϯ26 (maximal) at the side of the fingers (PϽ0.001 for all). Orthogonal polarization spectral imaging also showed a significant increase in capillary density both at the dorsum of the fingers and the web. Subgroup analysis showed that most of the changes were significant in all of the ethnic groups. Furthermore, there was a significant relationship between the change in 24-hour urinary sodium and the change in capillary density at the side of the fingers. These results demonstrate that a modest reduction in salt intake, as currently recommended, improves both functional and structural capillary rarefactions that occur in hypertension, and a larger reduction in salt intake would have a greater effect. The increase in capillary density may possibly carry additional beneficial effects on target organs. (Hypertension. 2010;56:253-259.)Key Words: sodium Ⅲ dietary Ⅲ microcirculation Ⅲ capillary rarefaction Ⅲ hypertension Ⅲ randomized trial M icrovascular rarefaction, that is, a reduction in the number of arterioles and capillaries, is found in many animal models of hypertension and in human hypertension. 1,2 We have shown previously that much of the reduction in capillary density in essential hypertension was because of the structural (anatomic) absence of capillaries, 2 although functional capillary rarefaction (because of nonperfusion) also existed. 1 Our previous studies also suggested that capillary rarefaction was likely to be a primary vascular abnormality. 3,4 Microvascular rarefaction increases peripheral vascular resistance, thereby increasing blood pressure (BP) and aggravating BP-related target organ damage. 1 At the same time, a reduction in the microvascular network may decrease tissue perfusion 5 and cause gradual impairments of tissues and organs. Two studies have implied that long-term effective antihypertensive treatments may reverse microvascular rarefaction in nondiabetic individuals with raised BP. 6 -8 Studies in rats demonstrated that a high-salt intake caused a significant loss of microvessels, 9,10 which occurred within a few days. 10 However, no controlled trial in humans has studied whether a modest reduction in salt intake has an effect on microcirculation.Direct in...

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“…In OPS imaging, the tissue embedding the microcirculation is illuminated with polarised green light [60,133,[141][142][143]. As in the case of PS imaging, backscattered (and thus depolarised) light is projected onto a CCD camera after it passes an analyzer.…”

Section: Side-stream Dark Field Illuminationmentioning

confidence: 99%

‘Go with the flow ’: A review of methods and advancements in blood flow imaging

Daly

Leahy

2012

Journal of Biophotonics

106

108

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Physics has delivered extraordinary developments in almost every facet of modern life. From the humble thermometer and stethoscope to X‐Ray, CT, MRI, ultrasound, PET and radiotherapy, our health has been transformed by these advances yielding both morphological and functional metrics. Recently high resolution label‐free imaging of the microcirculation at clinically relevant depths has become available in the research domain. In this paper, we present a comprehensive review on current imaging techniques, state‐of‐the‐art advancements and applications, and general perspectives on the prospects for these modalities in the clinical realm. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)

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OPS Imaging of Human Microcirculation: A Short Technical Report

Cited by 81 publications

References 10 publications

Changes in Microcirculation as Early Markers for Infection in Preterm Infants—An Observational Prospective Study

Changes in Microcirculation as Early Markers for Infection in Preterm Infants—An Observational Prospective Study

Effect of Modest Salt Reduction on Skin Capillary Rarefaction in White, Black, and Asian Individuals With Mild Hypertension

‘Go with the flow ’: A review of methods and advancements in blood flow imaging

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