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Related Experiment Videos

Peripheral vascular tone in sepsis.

M E Astiz1, E Tilly, E D Rackow

  • 1St. Vincent's Hospital and Medical Center of New York, NY.

Chest
|May 1, 1991
PubMed
Summary
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Changes in forearm vascular tone, including decreased venous capacity and increased venous tone, are early indicators of sepsis severity. These vascular alterations, along with reduced blood flow and hyperemic response, are most pronounced in septic shock patients with circulatory failure.

Area of Science:

  • Physiology
  • Pathophysiology
  • Vascular Biology

Background:

  • Septic shock is a critical condition involving distributive circulatory failure.
  • Understanding microvascular dysfunction is crucial for managing sepsis progression.

Purpose of the Study:

  • To investigate the relationship between forearm arterial, venous, and microvascular tone and sepsis severity.
  • To identify early markers of sepsis-induced circulatory changes.

Main Methods:

  • Air plethysmography was used to measure forearm venous capacity (MVC), forearm venous tone (F-VT), arterial blood flow (FBF), forearm arterial resistance (FAR), and hyperemic response (FBF-RH).
  • The study included control patients, patients with sepsis, and patients with sepsis and shock, excluding those on vasoactive drugs.

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Main Results:

  • Septic and septic shock patients exhibited decreased MVC and increased F-VT.
  • Reduced FBF and slightly increased FAR were observed in septic and septic shock groups.
  • Forearm hyperemic response (FBF-RH) was significantly diminished in both sepsis groups.
  • Decreased F-VT and blunted hyperemic response occurred early, even without clinical hypoperfusion signs.

Conclusions:

  • Changes in forearm vascular tone and microvascular reactivity are early indicators of sepsis severity.
  • These vascular alterations are proportional to sepsis severity and most severe in patients with circulatory failure (septic shock).
  • Progressive skeletal muscle vasodilation was not a primary feature in severe sepsis in this cohort.