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Critical Care Research and Practice
Volume 2012, Article ID 372956, 7 pages
http://dx.doi.org/10.1155/2012/372956
Clinical Study

The Microcirculation Is Unchanged in Neonates with Severe Respiratory Failure after the Initiation of ECMO Treatment

1Intensive Care, Erasmus Medical Center-Sophia Children’s Hospital, University Medical Center, P.O. Box 2060, 3000 CB, Rotterdam, The Netherlands
2Pediatric Intensive Care Unit, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
3Department of Intensive Care, Erasmus Medical Center, University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands

Received 29 December 2011; Revised 13 March 2012; Accepted 22 March 2012

Academic Editor: Arnaldo Dubin

Copyright © 2012 Anke P. C. Top 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

Purpose. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is known to improve cardiorespiratory function and outcome in neonates with severe respiratory failure. We tested the hypothesis that VA-ECMO therapy improves the microcirculation in neonates with severe respiratory failure. Methods. This single-center prospective observational pilot study took place in an intensive care unit of a level III university children’s hospital. Twenty-one-term neonates, who received VA-ECMO treatment, were included. The microcirculation was assessed in the buccal mucosa, using Orthogonal Polarization Spectral imaging, within 24 hours before (T1) and within the first 24 hours after initiation of ECMO treatment (T2). Data were compared to data of a ventilated control group ( 𝑁 = 7 ). Results. At baseline (T1), median functional capillary density (FCD), microvascular flow index (MFI), and heterogeneity index (HI) did not differ between the ECMO group and the control group. At T2 the median FCD was lower in the control group (median [range]: 2.4 [1.4–4.2] versus 4.3 [2.8–7.4] cm/cm2; P value <0.001). For MFI and HI there were no differences at T2 between the two groups. Conclusion. The perfusion of the microcirculation does not change after initiation of VA-ECMO treatment in neonates with severe respiratory failure.