ArticleIntensive care medicine2012
Changes in the sublingual microcirculation and endothelial adhesion molecules during the course of severe meningococcal disease treated in the paediatric intensive care unit.
Article in Intensive care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Relevance of Microvascular Flow Assessments in Critically Ill Neonates and Children: A Systematic Review.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2020Pooled it
- Pharmacokinetics of a novel sublingual spray formulation of the antimalarial drug artemether in African children with malaria.Antimicrobial agents and chemotherapy · 2015Trial
- End organ perfusion and pediatric microcirculation assessment.Frontiers in pediatrics · 2023Review
- Efficacy of CytoSorb in a Pediatric Case of Severe Multisystem Infammatory Syndrome (MIS-C): A Clinical Case Report.Frontiers in pediatrics · 2021Article
- Recommendations for hemodynamic monitoring for critically ill children-expert consensus statement issued by the cardiovascular dynamics section of the European Society of Paediatric and Neonatal Intensive Care (ESPNIC).Critical care (London, England) · 2020Article
- Childhood Obesity, Endothelial Cell Activation, and Critical Illness.Frontiers in pediatrics · 2020Review
- The compelling arguments for the need of microvascular investigation in COVID-19 critical patients.Clinical hemorheology and microcirculation · 2020Article
- Assessing the Microcirculation With Handheld Vital Microscopy in Critically Ill Neonates and Children: Evolution of the Technique and Its Potential for Critical Care.Frontiers in pediatrics · 2019Review
- Microcirculatory Differences in Children With Congenital Heart Disease According to Cyanosis and Age.Frontiers in pediatrics · 2019Article
- Approach of minimal invasive monitoring and initial treatment of the septic patient in emergency medicine.Open access emergency medicine : OAEM · 2018Review
- Review
- The vulnerable microcirculation in the critically ill pediatric patient.Critical care (London, England) · 2016Review
- Association of Microvascular Function and Endothelial Biomarkers With Clinical Outcome in Dengue: An Observational Study.The Journal of infectious diseases · 2016Observational
- Endothelial and Microcirculatory Function and Dysfunction in Sepsis.Clinics in chest medicine · 2016Review
- In vivo microscopy of hemozoin: towards a needle free diagnostic for malaria.Biomedical optics express · 2015Article
- Soluble adhesion molecules as markers for sepsis and the potential pathophysiological discrepancy in neonates, children and adults.Critical care (London, England) · 2014Review
- Non-invasive imaging of microcirculation: a technology review.Medical devices (Auckland, N.Z.) · 2014Review
- Review
- Evaluation of sublingual microcirculation in children with dengue shock.Clinics (Sao Paulo, Brazil) · 2013Article
- Year in review in Intensive Care Medicine 2012: III. Noninvasive ventilation, monitoring and patient-ventilator interactions, acute respiratory distress syndrome, sedation, paediatrics and miscellanea.Intensive care medicine · 2013Review
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe sublingual microcirculation can be visualised in real time using sidestream dark-field (SDF) imaging. Endothelial activation mediated through adhesion molecules may alter flow patterns in the microcirculation. We studied sublingual microcirculatory disturbances in children with meningococcal disease (MCD) and simultaneously measured plasma levels of adhesion molecules.
methodTwenty children admitted to the paediatric intensive care unit (PICU) with MCD were studied. Forty healthy children were controls. The sublingual microcirculation was assessed at admission and at timed intervals until extubation. The microvascular flow index (MFI), capillary density (CD), proportion of perfused vessels (PPV) and perfused vessel density (PVD) were measured using SDF imaging. Plasma intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin and P-selectin were measured at admission and at timed intervals during the course of PICU treatment.
resultsSignificant reductions in MFI, CD, PPV and PVD were found in children with MCD compared with controls (p < 0.005). These differences had resolved prior to extubation. Initial MFI values predicted the duration of mechanical ventilation, irrespective of the stage of illness at the time of presentation to PICU. There were negative correlations between the ICAM-1, VCAM-1 and E-selectin levels and the microcirculatory MFI and PPV values at the time of admission to PICU (p < 0.005).
conclusionsMicrocirculatory dysfunction is present in children with severe MCD with improvement alongside clinical recovery. Microcirculatory dysfunction correlated with markers of endothelial activation. Sublingual SDF imaging is feasible in children ventilated on PICU for severe sepsis and may prove useful in studies assessing illness severity and therapy.
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Registered trials
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