PMC10415601_01
Plugged vessels next to vessels with flowing cells (type 3 microcirculatory alterations)
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F1
As the next diagnostic step, sublingual microcirculation was visualized and assessed, revealing plugged vessels next to vessels with flowing cells (type 3 microcirculatory alterations, Figure 1).
Aggravation of microcirculatory flow due to excessive vasoconstriction (type 1 and type 3 microcirculatory alterations)
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F2
A second assessment of sublingual microcirculation performed five minutes after the third dose of phenylephrine revealed further deterioration of microcirculatory flow with complete stagnated capillaries (type 1 alterations) in addition to type 3 alterations (Figure 2), suggesting microcirculatory shock due to excessive vasoconstriction.
A small improvement in microcirculatory flow was observed 20 min after the start of glyceryl trinitrate infusion
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F3
Twenty minutes later, a third assessment of sublingual microcirculation revealed a small improvement in microcirculatory flow (Figure 3).
Increasing the dose of glyceryl trinitrate significantly improved microcirculatory flow
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F4
Another assessment at that time (glyceryl trinitrate 0.42 mug kg-1 min-1) revealed improved sublingual microcirculatory flow (Figure 4).