30 September 2009
Intra-operative assessment of human pulmonary alveoli in vivo using Sidestream Dark Field imaging: a feasibility study
Corstiaan den UilABCDEF, Rick BezemerBC, Dinis R. MirandaAF, Can InceDE, Wim K. LagrandDE, Michael HartmanB, Ad J. BogersBE, Peter E. SpronkADF, Maarten L. SimoonsEGMed Sci Monit 2009; 15(10): MT137-141 :: ID: 878199
Abstract
Background
In vivo videomicroscopy has been used for years to visualize subpleural alveoli in animal studies. This has led to a better understanding of alveolar physiology. We tested the hypothesis whether a novel handheld videomicroscope could be used for intraoperative detection of alveoli in surgical patients during mechanical ventilation.
Material and Method
Using Sidestream Dark Field imaging, we observed 6 patients (3 adults and 3 children) who underwent elective cardiac surgery. In each patient, the tip of the microscope was placed on the visceral pleural surface of the left upper pulmonary lobe after weaning from cardiopulmonary bypass. The acquired images were converted into digital signals and captured on a computer.
Results
Although cardiac motion artifacts were present, visceral pleural microvascular blood flow could be observed in adults and infants. In infants, sub-pleural cavities (alveoli) were observed. These alveoli were remarkably similar in dimension and structure to those identified previously as true alveoli in animal studies. Quantification of these alveoli demonstrated that mean alveolar diameter, perimeter and area increased with age among the investigated infants (all parameters p<0.001).
Conclusions
High-quality images of visceral pleural microvessels as well as subpleural cavities, reflecting superficial alveoli, could be obtained in infants. These findings create the opportunity to begin human intervention studies, which should investigate alveolar dynamics during mechanical ventilation in cardio-thoracic surgery in more detail.
Keywords: Microcirculation, Intraoperative Care, Feasibility Studies, Diagnostic Imaging - methods, Child, Preschool, Aged, 80 and over, Pulmonary Alveoli - pathology
Editorial
01 May 2024 : Editorial
Editorial: First Regulatory Approval for Adoptive Cell Therapy with Autologous Tumor-Infiltrating Lymphocytes (TILs) – Lifileucel (Amtagvi)DOI: 10.12659/MSM.944927
Med Sci Monit 2024; 30:e944927
In Press
14 Mar 2024 : Clinical Research
Differential DHA and EPA Levels in Women with Preterm and Term Births: A Tertiary Hospital Study in IndonesiaMed Sci Monit In Press; DOI: 10.12659/MSM.943895
15 Mar 2024 : Clinical Research
Evaluation of an Optimized Workflow for the Radiofrequency Catheter Ablation of Paroxysmal Atrial FibrillationMed Sci Monit In Press; DOI: 10.12659/MSM.943526
09 May 2024 : Review article
A Review of the Current Status of Disease-Modifying Therapies and Prevention of Alzheimer’s DiseaseMed Sci Monit In Press; DOI: 10.12659/MSM.945091
09 Apr 2024 : Clinical Research
Correlation between Thalamocortical Tract and Default Mode Network with Consciousness Levels in Hypoxic-Isc...Med Sci Monit In Press; DOI: 10.12659/MSM.943802
Most Viewed Current Articles
17 Jan 2024 : Review article
Vaccination Guidelines for Pregnant Women: Addressing COVID-19 and the Omicron VariantDOI :10.12659/MSM.942799
Med Sci Monit 2024; 30:e942799
14 Dec 2022 : Clinical Research
Prevalence and Variability of Allergen-Specific Immunoglobulin E in Patients with Elevated Tryptase LevelsDOI :10.12659/MSM.937990
Med Sci Monit 2022; 28:e937990
16 May 2023 : Clinical Research
Electrophysiological Testing for an Auditory Processing Disorder and Reading Performance in 54 School Stude...DOI :10.12659/MSM.940387
Med Sci Monit 2023; 29:e940387
01 Jan 2022 : Editorial
Editorial: Current Status of Oral Antiviral Drug Treatments for SARS-CoV-2 Infection in Non-Hospitalized Pa...DOI :10.12659/MSM.935952
Med Sci Monit 2022; 28:e935952