{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T04:50:47Z","timestamp":1749271847559,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T00:00:00Z","timestamp":1655683200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Anesthesia"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While non\u2010invasive assessment of macro\u2010 and micro\u2010circulation has the promise to optimize anesthesia management, evidence is lacking for the relationship between invasive and non\u2010invasive measurements of cardiac output and microcirculatory indices.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>We aimed to compare the abilities of non\u2010invasive techniques to detect changes in macro\u2010 and micro\u2010circulation following deep anesthesia and subsequent restoration of the compromised hemodynamic by routinely used vasopressors in a randomized experimental study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A 20%\u201325% drop in mean arterial pressure was induced by sevoflurane in anesthetized mechanically ventilated just\u2010weaned piglets (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) prior to the administration of vasopressors in random order (dopamine, ephedrine, noradrenaline, and phenylephrine). Simultaneous transpulmonary thermodilution cardiac output assessment with the invasive pulse index continuous contour (PiCCO) method was compared with non\u2010invasive estimates obtained with electrical conductivity (ICON) and echo Doppler (Cardio <jats:italic>Q<\/jats:italic>). Changes in microcirculation were characterized by sublingual red blood cell velocity, jugular cerebral venous oxygen saturation, and arterial lactate.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Cardiac output indices obtained by invasive and non\u2010invasive methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Changes in cardiac output measured invasively and non\u2010invasively correlated significantly after sevoflurane (<jats:italic>r<\/jats:italic>\u00a0=\u00a0.78, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.003 and <jats:italic>r<\/jats:italic>\u00a0=\u00a0.76, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.006 between PiCCO and ICON or Cardio <jats:italic>Q<\/jats:italic>, respectively). Following the administration of vasopressors, invasive and non\u2010invasive cardiac output assessments were unrelated with significant correlations observed only between PiCCO and ICON after dopamine and ephedrine. Sevoflurane\u2010induced hypotension decreased jugular cerebral venous oxygen saturation significantly and was recovered by all vasopressors. Sevoflurane and vasopressors had no effect on red blood cell velocity, which increased only after dopamine. No consistent changes in lactate were observed during the study period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results of this study suggest that non\u2010invasive cardiac output measurements may not accurately reflect changes in macrocirculation after hemodynamic optimization by vasopressors. Due to the incoherence between macro\u2010 and micro\u2010circulation, monitoring microcirculation is essential to guide patient management.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pan.14506","type":"journal-article","created":{"date-parts":[[2022,6,5]],"date-time":"2022-06-05T02:48:24Z","timestamp":1654397304000},"page":"1129-1137","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Invasive and non\u2010invasive assessment of macro\u2010 and micro\u2010circulatory effects of vasopressors during sevoflurane anesthesia in a pediatric experimental model: A randomized trial"],"prefix":"10.1111","volume":"32","author":[{"given":"Rita","family":"Kallab","sequence":"first","affiliation":[{"name":"Unit for Anaesthesiological Investigations, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine University Hospitals of Geneva and University of Geneva  Geneva Switzerland"},{"name":"Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roberta","family":"Sudy","sequence":"additional","affiliation":[{"name":"Unit for Anaesthesiological Investigations, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine University Hospitals of Geneva and University of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6038-8500","authenticated-orcid":false,"given":"Andre","family":"Dos Santos Rocha","sequence":"additional","affiliation":[{"name":"Unit for Anaesthesiological Investigations, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine University Hospitals of Geneva and University of Geneva  Geneva Switzerland"},{"name":"Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Diaper","sequence":"additional","affiliation":[{"name":"Unit for Anaesthesiological Investigations, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine University Hospitals of Geneva and University of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferenc","family":"Petak","sequence":"additional","affiliation":[{"name":"Department of Medical Physics and Informatics University of Szeged  Szeged Hungary"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gleicy","family":"Keli Barcelos","sequence":"additional","affiliation":[{"name":"Division of Anaesthesiology, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6521-5091","authenticated-orcid":false,"given":"Walid","family":"Habre","sequence":"additional","affiliation":[{"name":"Unit for Anaesthesiological Investigations, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine University Hospitals of Geneva and University of Geneva  Geneva Switzerland"},{"name":"Paediatric Anesthesia Unit, Department of Anaesthesiology, Pharmacology, Intensive Care and Emergency Medicine University Hospitals of Geneva  Geneva Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,6,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1080\/10739680802350112"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc12727"},{"issue":"5","key":"e_1_2_11_4_1","first-page":"H1581","article-title":"Neural regulation of 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