The Microcirculation and Its Measurement in Sepsis

Overview

Journal J Intensive Care Soc

Publisher Sage Publications

Specialty Critical Care

Date 2017 Nov 10

PMID 29118834

Citations 31

Authors

Matthew Charlton

Mark Sims

Tim Coats

Jonathan P Thompson

Affiliations

Soon will be listed here.

Abstract

The microcirculation describes the smallest elements of the cardiovascular conducting system and is pivotal in the maintenance of homeostasis. Microcirculatory dysfunction is present early in the pathophysiology of sepsis, with the extent of microcirculatory derangement relating to disease severity and prognosis in ICU patients. However, at present microcirculatory function is not routinely monitored at the bedside. This article describes the pathophysiology of microcirculatory derangements in sepsis, methods of its measurement and evidence to support their clinical use.

Citing Articles

Myocardial Injury as a Harbinger of Multi-organ Failure in Septic Shock: A Comprehensive Review.

Singam A Cureus. 2024; 16(2):e55021.

PMID: 38550421 PMC: 10975005. DOI: 10.7759/cureus.55021.

Point-of-care and traditional erythrocyte sedimentation rate, point-of-care rheometry, and cell-free DNA concentration in dogs with or without systemic inflammation.

Clarkin-Breslin R, Brainard B J Vet Diagn Invest. 2024; 36(2):177-186.

PMID: 38372154 PMC: 10929639. DOI: 10.1177/10406387241226971.

Navigating the Landscape of Hydrocortisone Administration in Septic Shock: Current Concepts and Future Directions.

Kommareddy Jr A, Vagha J, Meshram R Cureus. 2024; 15(12):e49870.

PMID: 38169849 PMC: 10758589. DOI: 10.7759/cureus.49870.

Relationship between peripheral ischemic microvascular reserve, persistent hyperlactatemia, and its temporal dynamics in sepsis: a post hoc study.

Miranda A, do Carmo De Stefani F, Vesco B, Carraro Junior H, Assreuy J, Morello L Crit Care Sci. 2023; 35(2):177-186.

PMID: 37712807 PMC: 10406409. DOI: 10.5935/2965-2774.20230348-en.

Demonstration of ameliorating effect of papaverine in sepsis-induced acute lung injury on rat model through radiology and histology.

Ozkul B, Sever I, Yigitturk G, Elgormus C, Gur S, Erbas O Ulus Travma Acil Cerrahi Derg. 2023; 29(9):963-971.

PMID: 37681716 PMC: 10560817. DOI: 10.14744/tjtes.2023.73580.

References

De Backer D, Hollenberg S, Boerma C, Goedhart P, Buchele G, Ospina-Tascon G . How to evaluate the microcirculation: report of a round table conference. Crit Care. 2007; 11(5):R101. PMC: 2556744. DOI: 10.1186/cc6118. View

Aykut G, Veenstra G, Scorcella C, Ince C, Boerma C . Cytocam-IDF (incident dark field illumination) imaging for bedside monitoring of the microcirculation. Intensive Care Med Exp. 2015; 3(1):40. PMC: 4512989. DOI: 10.1186/s40635-015-0040-7. View

Sakr Y, Dubois M, De Backer D, Creteur J, Vincent J . Persistent microcirculatory alterations are associated with organ failure and death in patients with septic shock. Crit Care Med. 2004; 32(9):1825-31. DOI: 10.1097/01.ccm.0000138558.16257.3f. View

Scheeren T . Journal of Clinical Monitoring and Computing 2015 end of year summary: tissue oxygenation and microcirculation. J Clin Monit Comput. 2016; 30(2):141-6. PMC: 4792340. DOI: 10.1007/s10877-016-9846-4. View

Pareznik R, Knezevic R, Voga G, Podbregar M . Changes in muscle tissue oxygenation during stagnant ischemia in septic patients. Intensive Care Med. 2005; 32(1):87-92. DOI: 10.1007/s00134-005-2841-8. View

De Backer D, Donadello K, Sakr Y, Ospina-Tascon G, Salgado D, Scolletta S . Microcirculatory alterations in patients with severe sepsis: impact of time of assessment and relationship with outcome. Crit Care Med. 2013; 41(3):791-9. DOI: 10.1097/CCM.0b013e3182742e8b. View

Contenti J, Occelli C, Corraze H, Lemoel F, Levraut J . Long-Term β-Blocker Therapy Decreases Blood Lactate Concentration in Severely Septic Patients. Crit Care Med. 2015; 43(12):2616-22. DOI: 10.1097/CCM.0000000000001308. View

Gomez H, Mesquida J, Simon P, Kim H, Puyana J, Ince C . Characterization of tissue oxygen saturation and the vascular occlusion test: influence of measurement sites, probe sizes and deflation thresholds. Crit Care. 2009; 13 Suppl 5:S3. PMC: 2786105. DOI: 10.1186/cc8001. View

Nanas S, Gerovasili V, Renieris P, Angelopoulos E, Poriazi M, Kritikos K . Non-invasive assessment of the microcirculation in critically ill patients. Anaesth Intensive Care. 2009; 37(5):733-9. DOI: 10.1177/0310057X0903700516. View

10.

Lush C, Kvietys P . Microvascular dysfunction in sepsis. Microcirculation. 2000; 7(2):83-101. DOI: 10.1038/sj.mn.7300096. View

11.

Guix F, Uribesalgo I, Coma M, Munoz F . The physiology and pathophysiology of nitric oxide in the brain. Prog Neurobiol. 2005; 76(2):126-52. DOI: 10.1016/j.pneurobio.2005.06.001. View

12.

Bazerbashi H, Merriman K, Toale K, Chaftari P, Carreras M, Henderson J . Low tissue oxygen saturation at emergency center triage is predictive of intensive care unit admission. J Crit Care. 2014; 29(5):775-9. DOI: 10.1016/j.jcrc.2014.05.006. View

13.

Payen D, Luengo C, Heyer L, Resche-Rigon M, Kerever S, Damoisel C . Is thenar tissue hemoglobin oxygen saturation in septic shock related to macrohemodynamic variables and outcome?. Crit Care. 2009; 13 Suppl 5:S6. PMC: 2786108. DOI: 10.1186/cc8004. View

14.

Umeyama S, Yamada T . New cross-talk measure of near-infrared spectroscopy and its application to wavelength combination optimization. J Biomed Opt. 2009; 14(3):034017. DOI: 10.1117/1.3147402. View

15.

Skarda D, Mulier K, Myers D, Taylor J, Beilman G . Dynamic near-infrared spectroscopy measurements in patients with severe sepsis. Shock. 2007; 27(4):348-53. DOI: 10.1097/01.shk.0000239779.25775.e4. View

16.

Ait-Oufella H, Lemoinne S, Boelle P, Galbois A, Baudel J, Lemant J . Mottling score predicts survival in septic shock. Intensive Care Med. 2011; 37(5):801-7. DOI: 10.1007/s00134-011-2163-y. View

17.

Vorwerk C, Coats T . The prognostic value of tissue oxygen saturation in emergency department patients with severe sepsis or septic shock. Emerg Med J. 2011; 29(9):699-703. DOI: 10.1136/emermed-2011-200160. View

18.

Shapiro N, Arnold R, Sherwin R, OConnor J, Najarro G, Singh S . The association of near-infrared spectroscopy-derived tissue oxygenation measurements with sepsis syndromes, organ dysfunction and mortality in emergency department patients with sepsis. Crit Care. 2011; 15(5):R223. PMC: 3334769. DOI: 10.1186/cc10463. View

19.

Ait-Oufella H, Joffre J, Boelle P, Galbois A, Bourcier S, Baudel J . Knee area tissue oxygen saturation is predictive of 14-day mortality in septic shock. Intensive Care Med. 2012; 38(6):976-83. DOI: 10.1007/s00134-012-2555-7. View

20.

Trzeciak S, McCoy J, Dellinger R, Arnold R, Rizzuto M, Abate N . Early increases in microcirculatory perfusion during protocol-directed resuscitation are associated with reduced multi-organ failure at 24 h in patients with sepsis. Intensive Care Med. 2008; 34(12):2210-7. PMC: 2821162. DOI: 10.1007/s00134-008-1193-6. View