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Micro- and Macrocirculatory Changes During Sepsis and Septic Shock in a Rat Model
Tianfeng Hua1,2, Xiaobo Wu1, Wei Wang1
1Weil Institute of Emergency and Critical Care Research, Virginia Commonwealth University, Richmond, Virginia.
Shock (Augusta, Ga.)
|July 22, 2017
Summary
Microcirculatory changes in sepsis occur before systemic hemodynamic shifts. Monitoring microcirculation, including buccal and renal, aids in early detection of circulatory failure during sepsis.
Area of Science:
- Sepsis research
- Hemodynamics
- Microcirculation
Background:
- Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection.
- Microcirculation plays a critical role in sepsis pathophysiology.
- Early detection of microcirculatory dysfunction is crucial for timely intervention.
Purpose of the Study:
- To investigate if microcirculatory alterations precede systemic hemodynamic changes in a rat model of sepsis.
- To compare renal microcirculatory changes with buccal microcirculation during sepsis.
Main Methods:
- Utilized a cecum ligation and puncture (CLP) rat model of sepsis.
- Employed sidestream dark field (SDF) video microscopy to assess perfused microvessel density (PVD) and microvascular flow index (MFI).
- Simultaneously measured systemic hemodynamic parameters, cytokines (IL-6), and blood markers.
Main Results:
- Microcirculatory alterations in both buccal and renal tissues were observed as early as 180 minutes post-CLP.
- Systemic hemodynamic parameters, including mean arterial pressure (MAP) and cardiac output (CO), remained unchanged until 300 minutes post-CLP.
- Renal microcirculatory changes correlated with buccal microcirculatory changes.
Conclusions:
- Microcirculatory dysfunction occurs earlier than systemic hemodynamic changes in sepsis.
- Monitoring microcirculation offers a potential method for early diagnosis of circulatory failure in sepsis.
- Renal and buccal microcirculation exhibit similar changes during sepsis and septic shock.
