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International Journal of Pediatrics
Volume 2013 (2013), Article ID 768784, 6 pages
http://dx.doi.org/10.1155/2013/768784
Clinical Study

Microcirculatory Changes in Term Newborns with Suspected Infection: An Observational Prospective Study

1Division of Neonatology Perinatal Center, Department of Gynecology and Obstetrics, Ludwig-Maximilians University Munich, 80337 Munich, Germany
2Division of Neonatology, University Children’s Hospital, Ludwig-Maximilians University Munich, 80337 Munich, Germany

Received 21 October 2012; Revised 17 December 2012; Accepted 18 December 2012

Academic Editor: Mohan Pammi

Copyright © 2013 Irene Alba-Alejandre et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. In adults severely disturbed microcirculatory flow can be observed by Orthogonal Polarized Spectral (OPS) imaging techniques during sepsis. Therefore we set out to assess for microcirculatory changes in term newborns with suspected early onset infection using OPS. Methods. OPS images were obtained prospectively from the vascular bed of the ear conch and upper arm of 47 newborns on their 1st, 2nd, and 3rd day of life. OPS sequences were analyzed semiquantitatively offline and blinded to clinical status of the infant. Flow in vessels was classified as continuous or noncontinuous flow and given as proportion of total vessels per image as in the studies in adults. Results. The proportion of vessels with continuous flow was significantly lower in the infants with infection (69% [56–81] versus 90% [87–94] ). None of the infants with infection was in shock or severely septic. Conclusion. In term neonates the microcirculatory flow is impaired in a large proportion of vessels even in mild to moderate infection. These changes can be observed at the onset of disease at the external ear, an optimal site for microcirculatory measurements in term infants.