Assessments of skin and tongue microcirculation reveals major changes in porcine sepsis

To examine the relation between central hemodynamics, clinical severity and microvascular findings in tongue and skin during sepsis.

Skin and tongue microcirculation was examined using laser Doppler and video microscopy techniques before and 200 min after inducing sepsis in pigs (n=6) by inactivated Neisseria meningitides and in two control animals.

All infected pigs developed clinical signs of sepsis. Pericapillary bleedings developed in the tongue in the two pigs with the most severe disease. Capillary density increased in the groin skin in infected pigs after 200 min as compared to baseline (P<0·02). In the same period, mean capillary flow velocity was reduced in groin skin and tongue in septic pigs (P<0·02). At 200 min a fraction of capillaries had developed 'no flow' or 'brisk flow', patterns hardly seen at baseline. Laser Doppler perfusion was reduced in ear and tongue after 200 min (P<0·02 for both). The described pathology was more pronounced in the pigs with the most severe sepsis.

Capillary bleedings may be used as an early indication of severe sepsis. Examination of skin and tongue microcirculations may be used to characterize severity of sepsis and possibly to assess effect of treatment.