| Relationship between sublingual and intestinal microcirculatory perfusion in patients with abdominal sepsis. | |
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MedLine Citation:
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PMID: 17334238 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To evaluate the relation between sublingual and intestinal microcirculatory alterations in patients with abdominal sepsis. DESIGN: Prospective observational study. SETTING: A 23-bed mixed intensive care unit of a tertiary teaching hospital. PATIENTS: Twenty-three patients with abdominal sepsis and a newly constructed intestinal stoma were included in the study group. Nineteen outpatient healthy individuals with an intestinal stoma and ten nonsepsis patients with a <24-hr-old intestinal stoma were included as controls. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Orthogonal polarization spectral imaging of the sublingual and intestinal microcirculation was performed on days 1 and 3. In addition, variables of systemic hemodynamics, such as cardiac index, heart rate, blood pressure, central venous pressure, and dosages of vasopressor and inotropic agents, were obtained. On day 1 there was no correlation of the microvascular flow index between the sublingual and intestinal microcirculatory beds (Spearman's rho [rs] = .12; 95% confidence interval, -.51 to .31; p = .59). Furthermore, there was no significant correlation between microcirculatory alterations and variables of systemic circulation (rs <or= .25). On day 3, however, a correlation between sublingual and intestinal microcirculatory flow appeared to be restored (rs = .74; 95% confidence interval, .28-.92; p = .006), mainly due to a normalization of flow in both regions. CONCLUSIONS: On day 1 of abdominal sepsis there is a complete dispersion of flow, not only between hemodynamic compartments of a different order but also between the sublingual and intestinal microcirculation. Over time, both sublingual and intestinal microvascular flow indexes trended to normal values. |
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Authors:
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E Christiaan Boerma; Peter H J van der Voort; Peter E Spronk; Can Ince |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Critical care medicine Volume: 35 ISSN: 0090-3493 ISO Abbreviation: Crit. Care Med. Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-04-06 Completed Date: 2007-05-15 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1055-60 Citation Subset: AIM; IM |
Affiliation:
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Department of Physiology, Academic Medical Center, University of Amsterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen Aged Blood Pressure Female Heart Rate Hospital Mortality Humans Intensive Care Units Intestines / blood supply*, surgery Male Microcirculation Middle Aged Monitoring, Physiologic / methods* Mouth Floor / blood supply* Prospective Studies Sepsis / mortality, physiopathology* Severity of Illness Index Surgical Stomas |
| Comments/Corrections | |
Comment In:
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Crit Care Med. 2007 Apr;35(4):1204-5
[PMID:
17413791
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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