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Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs

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Published on: May 21, 2019

Changes in microcirculation variables in an acute endotoxaemic equine model.

Philipp K Sauter¹, Barbara Steblaj², Sabine B R Kästner^1,3

¹Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany.

Equine Veterinary Journal

|January 23, 2025

Summary

Experimental endotoxemia in horses altered microcirculation flow and heterogeneity, but fluid therapy and noradrenaline did not restore these variables to baseline levels. Further research is needed to understand these complex interactions.

Keywords:

endotoxaemia equine anaesthesia horse microcirculation side‐stream darkfield technique

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Area of Science:

Veterinary Medicine
Physiology
Critical Care

Background:

Microcirculation is crucial for linking systemic circulation to cellular metabolism.
Understanding microcirculatory changes during sepsis is vital for effective treatment.

Purpose of the Study:

To investigate microcirculatory heterogeneity during experimental endotoxemia in horses.
To evaluate the efficacy of fluid therapy and noradrenaline (NA) in normalizing microcirculatory variables.

Main Methods:

In vivo study in six anesthetized horses subjected to experimental endotoxemia.
Microcirculation variables (MFI, HI, tSO2, etc.) assessed using side-stream darkfield, laser Doppler, and white light spectrometry.
Fluid bolus and NA infusion administered to achieve normotension.

Main Results:

Endotoxemia significantly decreased microvascular flow index (MFI) and increased heterogeneity index (HI) in various tissues.
Tissue oxygen saturation (tSO2), blood flow, and vessel density remained largely unchanged.
Fluid therapy and NA failed to restore MFI and HI to baseline levels.

Conclusions:

Experimental endotoxemia induces significant alterations in microcirculatory flow and heterogeneity.
Current fluid and NA strategies may not fully normalize these microcirculatory derangements.
Limitations include lack of a control group and inability to quantify blood flow directly.