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In patients with stroke from middle cerebral artery occlusion who underwent decompressive craniectomy, brain microcirculatory density and flow were significantly altered when compared to control patients [ 34].
Optimizing microcirculatory density and perfusion has become the focus of new clinical studies and microcirculatory images are therefore gaining a more prominent role in clinical research.
In addition, it was determined whether transfusion of either non-leukodepleted or leukodepleted packed RBC units could increase microcirculatory density and reactivity to improve tissue oxygenation during sepsis.
In contrast, our group has demonstrated an increased sublingual microcirculatory density and tissue oxygenation after transfusion of one to three RBC units with a mean age of 18 days in cardiac surgery patients [ 39].
Sublingual microcirculatory density and flow were monitored by using sidestream dark field (SDF) imaging (Microscan; Microvision Medical BV, Amsterdam, The Netherlands); details on the SDF imaging technique have been described elsewhere [ 26].
The current guidelines for microcirculatory image acquisition dictate that three to five microcirculatory sites should be measured per time point with a minimal recording time of 20 s per site to allow reliable analysis of microcirculatory density and perfusion [ 53].
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In a recent study that evaluated perioperative RBC transfusions in patients who underwent cardiac surgery using SDF and sublingual reflectance spectrophotometry, Yuruk et al. showed that RBC transfusion improved sublingual microcirculatory density, but not perfusion velocity, and improved microcirculatory oxygen saturation [54].
In a recent study that evaluated perioperative RBC transfusions in patients who underwent cardiac surgery using SDF and sublingual reflectance spectrophotometry, Yuruk et al. showed that RBC transfusion improved sublingual microcirculatory density, but not perfusion velocity, and improved microcirculatory oxygen saturation [ 54].
Parallel to the findings by Sakr and colleagues, we have recently conducted a pilot study to investigate the efficacy of RBC transfusions to improve microcirculatory density in adult septic patients and also found no improvement in the microcirculation after blood transfusion in these patients [ 40].
Microcirculatory density can be assessed as the total vessel density (TVD), including perfused and non-perfused micro-vessels, and perfused vessel density (PVD), including perfused microvessels only.
In rodents, administration of vitamin C improved microcirculatory perfusion, increasing capillary density and decreasing the number of stopped flow capillaries [9, 51].
More suggestions(11)
microcirculatory failure and
microcirculatory vascularity and
microcirculatory oxygenation and
microcirculatory flow and
microcirculatory unit and
microcirculatory perfusion and
microcirculatory function and
microcirculatory imaging and
microcirculatory vasodilation and
microcirculatory injury and
microcirculatory hypoperfusion and
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