Assessment of the microcirculation in the neonate
In this chapter we have discussed some of the tools and techniques necessary to understand more about the microvasculature in the newborn, specifically the preterm human infant. There is a significant pattern, in the first few days of postnatal life, of increased microvascular flow in premature infants with poorer outcome; specifically in those with male gender, earlier gestations and higher predictive clinical severity scores. We have demonstrated that this appears to be a systemic effect, associated with known vasomediators and have discussed the potential role of newer members of the vasomediator family, such as carbon monoxide and hydrogen sulfide. It is clear that much more work needs to be done, both to understand the microvascular function and effects, their hormonal modulators, their antecedents, and long-term consequences. Importantly, current and future studies should endeavor to include studying the physiology and pathophysiology of the microvasculature into research of the cardiovascular system of the newborn.