Microcirculation in critically ill children

Abstract

The aims of this thesis were to assess the feasibility of orthogonal polarization spectral (OPS) imaging of the buccal microcirculation in children and to investigate the effect of disease and critical care treatments on microcirculatory hemodynamics. To fulfil these aims two groups of children were studied: those with presumably normal microcirculation and those who were critically ill with severe respiratory failure or with sepsis. Routine hemodynamic monitoring in critically ill pediatric patients has limitations. Restoration of global hemodynamics does not always mean that adequate regional tissue perfusion is achieved, especially in conditions of impaired autoregulation such as occurs during critical illness. The microcirculation is an essential hemodynamic compartment and as such plays an important role in (patho-) physiology of the circulation. Taken together, monitoring the microcirculation, possibly, could be a valuable addition to the hemodynamic monitoring of the critically ill pediatric patient.