Publication: Utilidad de la microscopía de campo oscuro lateral en la evaluación de la microcirculación en el niño en estado crítico
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2019-02-19
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Universidad Complutense de Madrid
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Abstract
El compartimento microcirculatorio incluye los vasos en los que tiene lugar el intercambio de sustancias a nivel tisular. Su adecuado funcionamiento es crucial, especialmente en el paciente crítico. Sin embargo, su evaluación se ha realizado de manera indirecta y poco precisa. La videomicroscopía mediante imagen de campo oscuro lateral (SDF) permite evaluar visual y objetivamente su funcionamiento proporcionando información sobre la densidad y la funcionalidad vascular, el flujo sanguíneo y la microcirculatoria. La aplicación de esta técnica hasta el momento ha sido escasa; concretamente en niños existen muy pocos estudios clínicos y se desconoce si es posible aplicarla rutinariamente. Objetivos. Los objetivos principales de este trabajo han sido: evaluar la aplicabilidad de la técnica de evaluación microcirculatoria mediante microscopía SDF en pacientes pediátricos en estado crítico;valorar la capacidad de la microscopía SDF para detectar modificaciones en la situación microcirculatoria en diferentes situaciones fisiopatológicas en niños en estado crítico; y valorar la capacidad de la evaluación microcirculatoria para predecir la evolución de pacientes pediátricos enestado crítico...
Microcirculatory compartment involves all vessels in which substance exchange takes place in the tissues. Its correct functioning is crucial, especially in critically ill patients. However, its evaluation is made on inaccurate and indirect manner. Sidestream dark field imaging (SDF) videomicroscopy allows visual and objective evaluation of its function providing information about microcirculatory and vascular functioning and vascular density and blood flow. Until now application of this technique has been limited; concretely in children there are very few clinical studies and it is unknown if routine use is possible. Objectives. Main objectives of this work are: to evaluate applicability of the SDF microcirculatory evaluation in critically ill pediatric patients; to evaluate capability of SDF microscopy to detect changes in microcirculatory compartment in different physiopathological conditions in critically ill children; and to evaluate capability of microcirculatory evaluation to predict clinical evolution of critically ill pediatric patients...
Microcirculatory compartment involves all vessels in which substance exchange takes place in the tissues. Its correct functioning is crucial, especially in critically ill patients. However, its evaluation is made on inaccurate and indirect manner. Sidestream dark field imaging (SDF) videomicroscopy allows visual and objective evaluation of its function providing information about microcirculatory and vascular functioning and vascular density and blood flow. Until now application of this technique has been limited; concretely in children there are very few clinical studies and it is unknown if routine use is possible. Objectives. Main objectives of this work are: to evaluate applicability of the SDF microcirculatory evaluation in critically ill pediatric patients; to evaluate capability of SDF microscopy to detect changes in microcirculatory compartment in different physiopathological conditions in critically ill children; and to evaluate capability of microcirculatory evaluation to predict clinical evolution of critically ill pediatric patients...
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Tesis de la Universidad Complutense de Madrid, Facultad de Medicina, leída el 10-12-2018