Non-invasive imaging of the microcirculation in neonates
Research type
Research Study
Full title
Determining the optimal site for imaging the microcirculation in the neonate using orthogonal polarization spectral imaging (OPS).
IRAS ID
148464
Contact name
Andy Petros
Contact email
Sponsor organisation
Great Ormond Street Hospital for Children NHS foundation Trust & The UCL Institute of Child Health
Research summary
This work aims to increase our understanding of changes in microcirculation in neonates.
Changes in the microcirculation have a a significant impact on the development of tissue ischaemia, a condition similar to muscle cramps, but in various different body organs. Ischaemia can occur during sepsis or major bleeding or in chronic diseases. Until recently only major changes in circulation such as blood pressure or cardiac output were easily measurable. A more recent development was the introduction of intravital microscopy which gives real-time quantitative information on the microcirculation. This technique needs the use of a fluorescent dye and was thus restricted mostly to animal experiments. The significant breakthrough with this technique was the introduction of orthogonal polarization spectral (OPS) imaging which provides an ideal microcirculation monitor providing images of actual blood vessel but without the need for any contrast enhancement with dyes. Orthogonal Polarization Spectral Imaging (OPS) was superceded by SDF (Sidestream Darkfield Imaging), a similar method which gives clearer images in a 1x0.7mm field.
Although there have been sublingual imaging studies of the microcirculation in children with SDF, this is very difficult in neonates. Previous studies in neonates have been done by imaging axillary skin. This is an observational study to look at the feasibility of using other more accessible sites.
Persisting changes in microcirculatory perfusion scores have been shown to predict outcome in adults and correlate with severity of illness and markers of endothelial dysfunction in septic children.
Before we embark upon larger more detailed studies we need to determine the optimal site on the neonate from which we can get the best images of neonatal capillaries. We will ask parents of babies on our neonatal intensive care unit if we can take 5 images of 1x0.7mm in size from five predetermined sites on their baby.
REC name
London - Riverside Research Ethics Committee
REC reference
14/LO/1190
Date of REC Opinion
16 Jul 2014
REC opinion
Favourable Opinion