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Published on: December 10, 2020
Relationship between sublingual and intestinal microcirculatory perfusion in patients with abdominal sepsis
E Christiaan Boerma1, Peter H J van der Voort, Peter E Spronk
1Department of Physiology, Academic Medical Center, University of Amsterdam, The Netherlands.
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
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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