ArticleClinics (Sao Paulo, Brazil)2013
Evaluation of sublingual microcirculation in children with dengue shock.
Article in Clinics (Sao Paulo, Brazil), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 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.
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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
7 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
- Childhood Obesity, Endothelial Cell Activation, and Critical Illness.Frontiers in pediatrics · 2020Review
- Microcirculatory Differences in Children With Congenital Heart Disease According to Cyanosis and Age.Frontiers in pediatrics · 2019Article
- Review
- Association of Microvascular Function and Endothelial Biomarkers With Clinical Outcome in Dengue: An Observational Study.The Journal of infectious diseases · 2016Observational
- Predicting outcome from dengue.BMC medicine · 2014Review
- Fluid resuscitation therapy in endotoxemic hamsters improves survival and attenuates capillary perfusion deficits and inflammatory responses by a mechanism related to nitric oxide.Journal of translational medicine · 2014Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo report the sublingual microcirculation observed using Sidestream Dark Field imaging in two children with dengue shock.
methodTwo children, aged 9 and 10 years, were admitted to the pediatric intensive care unit with dengue shock and multiple organ dysfunction. Sublingual microcirculation was assessed in each patient on the first and second days of shock and was assessed a final time when the patients were no longer in shock (on the day prior to extubation) using Sidestream Dark Field technology. The De Backer score and microvascular flow index were used for the analyses.
resultsBoth patients had reduced perfused small vessel density in the first two days and showed predominantly intermittent or no microcirculation flow, as demonstrated by a low microvascular flow index. The blood flow in the large vessels was not affected. Prior to the extubation, the microvascular flow index had increased, although the perfused small vessel density remained diminished, suggesting persistent endothelial dysfunction.
conclusionsSevere microcirculation changes may be involved in the pathophysiological mechanisms that lead to the final stages of dengue shock, which is frequently irreversible and associated with high mortality rates. Microcirculatory monitoring may help elucidate the physiopathology of dengue shock and prove useful as a prognostic tool or therapeutic target.
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Registered trials
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