Imaging sublingual microcirculatory perfusion in pediatric patients receiving procedural sedation with propofol: A pilot study

M.A. Riedijk, D.M.J. Milstein

Research output: Contribution to JournalArticleAcademicpeer-review


Objective: Procedural sedation with propofol is widely used in the pediatric population. A well-known side effect of propofol is a decrease in peripheral vascular resistance resulting in hypotension, but little is known about the effects on microcirculation in humans. We aimed to evaluate the effects of propofol on the sublingual microcirculatory perfusion by continuous video imaging in pediatric patients undergoing procedural sedation.
Methods: Patients admitted to the Pediatric Intensive Care Unit for procedural sedation were recruited. Oral microcirculation was measured employing a continuous monitoring strategy with incident dark-field illumination imaging. Measurements were obtained before and 3 minutes after propofol induction. Total and perfused vessel densities, proportion of perfused vessels, microvascular flow index, blood vessel diameter (Øbv), and systemic hemodynamics were analyzed.
Results: Continuous measurements were achieved in seven patients. Three minutes after propofol induction mean arterial pressure decreased (P = 0.028) and total and perfused vessel densities increased by 12% (P = 0.018) and 16% (P = 0.018), respectively. MFI was unaltered and mean Øbv increased but not significantly.
Conclusions: Propofol induction induces a reduction in mean arterial pressure and a rise in sublingual microvascular perfusion. The observed effects of propofol on the sublingual microcirculation may be due to a decrease in microvascular resistance.
Original languageEnglish
Article numbere12484
Number of pages7
Issue number6
Publication statusPublished - 2018


Funding information Funding provided from department and institutional sources only. We would like to thank Frans Luteijn, sedation practitioner, for all the inductions and the dentistry students, Cem Ergin and Yaphet Fictoor, for their assistance on the blood vessel analysis. We also would like to thank all the patients and their parents for their interest and participation in this investigation. The cooperation, patience, and continued support of the medical staff involved with the procedural sedations are greatly appreciated.

FundersFunder number
Cem Ergin and Yaphet Fictoor


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