Endothelial Activation and Microcirculatory Disorders in Sepsis
Lisa Raia1, Lara Zafrani1,2
1Medical Intensive Care Unit, Hôpital Saint-Louis, Assistance Publique des Hôpitaux de Paris, Paris, France.
Frontiers in Medicine
|June 20, 2022
Summary
Sepsis triggers endothelial activation, which can cause microcirculatory damage and poor outcomes. Recognizing these microcirculatory alterations is key for identifying high-risk patients and guiding sepsis treatment.
Area of Science:
- Cardiovascular Biology
- Infectious Diseases
- Critical Care Medicine
Background:
- The vascular endothelium maintains vascular homeostasis.
- In sepsis, endothelial cells become activated, contributing to the host response.
- While necessary for pathogen elimination, excessive endothelial activation causes microcirculatory damage.
Purpose of the Study:
- To review endothelial activation and dysfunction in sepsis.
- To discuss bedside assessment of endothelial dysfunction.
- To highlight advances in microcirculatory resuscitation for sepsis.
Main Methods:
- Literature review of endothelial activation in sepsis.
- Analysis of microcirculatory alterations in sepsis.
- Synthesis of current therapeutic strategies for microcirculatory resuscitation.
Main Results:
- Endothelial activation in sepsis is a double-edged sword: essential for pathogen clearance but detrimental when excessive.
- Microcirculatory disorders are a hallmark of severe sepsis and correlate with poor patient outcomes.
- Bedside assessment tools and novel resuscitation strategies are emerging.
Conclusions:
- Understanding endothelial dysfunction in sepsis is critical for patient stratification.
- Improved recognition of microcirculatory changes can guide targeted interventions.
- Advances in microcirculatory resuscitation offer new hope for sepsis management.
