Wright, Ian M.R., Stark, M.J., and Dyson, R.M. (2019) Assessment of the microcirculation in the neonate. In: Seri, Istvan, and Kluckow, Martin, (eds.) Hemodynamics and Cardiology: Neonatology Questions and Controversies. Elsevier, Philadelphia, USA, pp. 327-340.

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Abstract

The dynamic physiologic changes that take place in the cardiovascular system of the preterm and term neonate during the transitional period are poorly characterized, especially when it comes to the role of the microvasculature. Indeed, most efforts to describe these changes focus on the determinants of blood pressure homeostasis: cardiac output and peripheral resistance. It is becoming increasingly evident that the microcirculation, composed of arterioles, capillaries, and venules less than 100 µm in diameter, is also crucial to the overall functioning of the cardiovascular system. Accordingly, in this chapter we discuss the changes in microvascular function during early extrauterine life and address their relationship to cardiovascular function, gestational age, clinical severity, and sex. The chapter also highlights the areas of interest and available methods in the study of the microvasculature of the newborn, including the tools available for investigating the microvascular structure and function in even the very immature neonate. Furthermore, the chapter also discusses the potential for and importance of the assessment of the microvasculature to aid in clinical decision-making and facilitates understanding the specific microvascular effects of common treatments of the critically ill preterm and term neonate.

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