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Updated: May 10, 2026
Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
Published on: August 26, 2014
Confocal laser endomicroscopy reliably detects sepsis-related and treatment-associated changes in intestinal mucosal
C Schmidt1, C Lautenschläger, B Petzold
1Clinic for Internal Medicine IV and.
Background:
Microcirculatory alterations play a central role in the pathophysiology of sepsis. We investigated probe-based confocal laser endomicroscopy (pCLE) to assess alterations in mucosal microcirculatory perfusion in vivo in a porcine model of septic shock and in patients fulfilling consensus criteria for severe sepsis.
Methods:
Septic shock was induced using a faecal peritonitis model in anaesthetized, mechanically ventilated pigs. Mucosal microcirculation was assessed using pCLE in the stomach, duodenum, terminal ileum, and rectum. Duodenal microcirculation was further evaluated in 10 patients with severe sepsis and in 8 healthy controls to quantify capillary diameter, capillary length, and functional capillary density (FCD).
Results:
In the animal model, FCD was markedly decreased in duodenal (P<0.001), ileal (P<0.001), gastric (P<0.001), and rectal mucosa (P<0.005) 4 h after induction of sepsis. After volume therapy, FCD partially recovered to 90.0% (duodenum), 94.4% (ileum), 95.4% (gastric), and 97% (rectum) of baseline values, indicating decoupling of microvascular and macrovascular flow. In septic patients, the mean capillary diameter (P<0.01) and FCD (P<0.05) in duodenal mucosa were decreased compared with healthy controls.
Conclusions:
pCLE reliably detected and quantified microcirculatory alterations in the gastrointestinal mucosa in a porcine model of sepsis and in patients with severe sepsis. Our data suggest that pCLE is a promising tool to assess the efficacy of therapeutic interventions on mucosal microcirculation in real-time, even in the clinical context.
Insights
Probe-based confocal laser endomicroscopy (pCLE) effectively identified microcirculatory changes in sepsis. This technique shows promise for real-time assessment of therapeutic interventions in gastrointestinal mucosal perfusion.
Area of Science:
- Gastroenterology
- Critical Care Medicine
- Medical Imaging
Background:
- Sepsis pathophysiology involves microcirculatory dysfunction.
- Assessing gastrointestinal mucosal perfusion is crucial in sepsis.
- Probe-based confocal laser endomicroscopy (pCLE) offers in vivo imaging capabilities.
Purpose of the Study:
- To evaluate pCLE for assessing microcirculatory alterations in sepsis.
- To investigate mucosal perfusion changes in a porcine model of septic shock.
- To quantify duodenal microcirculation in septic patients versus healthy controls.
Main Methods:
- Septic shock induced via fecal peritonitis in pigs.
- pCLE used to assess microcirculation in stomach, duodenum, ileum, and rectum.
- Duodenal microcirculation analyzed in 10 septic patients and 8 controls for capillary diameter, length, and functional capillary density (FCD).
Main Results:
- Sepsis significantly decreased FCD in all porcine gastrointestinal segments.
- Post-therapy, FCD partially recovered, suggesting macrovascular-microvascular decoupling.
- Septic patients showed reduced duodenal capillary diameter and FCD compared to controls.
Conclusions:
- pCLE reliably detects and quantifies sepsis-induced microcirculatory changes in gastrointestinal mucosa.
- pCLE is a valuable tool for real-time assessment of therapeutic interventions.
- The findings support pCLE's utility in clinical sepsis management.
