| Microvascular blood flow is altered in patients with sepsis. | |
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MedLine Citation:
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PMID: 12091178 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Microvascular blood flow alterations are frequent in animal models of sepsis and may impair tissue oxygenation. We hypothesized that alterations of the microcirculation are present in patients with sepsis. We used an orthogonal polarization spectral imaging technique to investigate the sublingual microcirculation in 10 healthy volunteers, 16 patients before cardiac surgery, 10 acutely ill patients without sepsis (intensive care unit control subjects), and 50 patients with severe sepsis. The effects of topical application of acetylcholine (10(-2) M) were tested in 11 patients with sepsis. In each subject, five to seven sublingual areas were recorded and analyzed semiquantitatively. Data were analyzed with nonparametric tests and are presented as medians (25th-75th percentiles). No significant difference in microvascular blood flow was observed between healthy volunteers and patients before cardiac surgery or intensive care unit control subjects. The density of all vessels was significantly reduced in patients with severe sepsis (4.5 [4.2-5.2] versus 5.4 [5.4-6.3]/mm in volunteers, p < 0.01). The proportion of perfused small (< 20 microm) vessels was reduced in patients with sepsis (48 [33-61] versus 90 [89-92]% in volunteers, p < 0.001). These alterations were more severe in nonsurvivors. The topical application of acetylcholine totally reversed these alterations. In conclusion, microvascular blood flow alterations are frequent in patients with sepsis and are more severe in patients with a worse outcome. |
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Authors:
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Daniel De Backer; Jacques Creteur; Jean-Charles Preiser; Marc-Jacques Dubois; Jean-Louis Vincent |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American journal of respiratory and critical care medicine Volume: 166 ISSN: 1073-449X ISO Abbreviation: Am. J. Respir. Crit. Care Med. Publication Date: 2002 Jul |
Date Detail:
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Created Date: 2002-07-01 Completed Date: 2002-07-30 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9421642 Medline TA: Am J Respir Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 98-104 Citation Subset: AIM; IM |
Affiliation:
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Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Belgium. ddebacke@ulb.ac.be |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acetylcholine
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administration & dosage,
pharmacology Administration, Sublingual Adult Aged Case-Control Studies Humans Image Interpretation, Computer-Assisted Microcirculation Microscopy, Polarization Middle Aged Mouth Mucosa / blood supply*, drug effects, physiopathology Severity of Illness Index Shock, Septic / physiopathology* Statistics, Nonparametric Vasodilator Agents / administration & dosage, pharmacology |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 51-84-3/Acetylcholine |
| Comments/Corrections | |
Comment In:
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Am J Respir Crit Care Med. 2002 Jul 1;166(1):1-2
[PMID:
12091157
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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