case_images: PMC10415601_01
case_images: Plugged vessels next to vessels with flowing cells (type 3 microcirculatory alterations)
case_images: AIT-55-50861-g001.jpg
case_images: PMC10415601_01_AIT-55-50861-g001.jpg
case_images: F1
case_images: 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).
case_images: Aggravation of microcirculatory flow due to excessive vasoconstriction (type 1 and type 3 microcirculatory alterations)
case_images: AIT-55-50861-g002.jpg
case_images: PMC10415601_01_AIT-55-50861-g002.jpg
case_images: F2
case_images: 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.
case_images: A small improvement in microcirculatory flow was observed 20 min after the start of glyceryl trinitrate infusion
case_images: AIT-55-50861-g003.jpg
case_images: PMC10415601_01_AIT-55-50861-g003.jpg
case_images: F3
case_images: Twenty minutes later, a third assessment of sublingual microcirculation revealed a small improvement in microcirculatory flow (Figure 3).
case_images: Increasing the dose of glyceryl trinitrate significantly improved microcirculatory flow
case_images: AIT-55-50861-g004.jpg
case_images: PMC10415601_01_AIT-55-50861-g004.jpg
case_images: F4
case_images: Another assessment at that time (glyceryl trinitrate 0.42 mug kg-1 min-1) revealed improved sublingual microcirculatory flow (Figure 4).