Comment on “Sublingual capnometry tracks microcirculatory changes in septic patients” by Creteur et al.

Excerpt

Sir: We read with great interest the study by Creteur et al. [1]. In resuscitated septic shock patients they demonstrated that increasing systemic blood flow using the β-adrenoreceptor agonist dobutamine at 5 μg/kg per minute augments capillary surface area in the tongue by increasing the number of perfused capillaries. Simultaneously observed were a significant decrease in sublingual carbon dioxide pressure (PslCO₂) and gastric mucosal to the arterial PCO₂ gradient (PgCO₂ gap), an increase in mixed venous oxygen saturation, and a small but significant decrease in blood lactate concentration. The latter findings were related to an existing tissue oxygen supply deficit before dobutamine infusion. The authors concluded that microcirculatory blood flow alterations are present in their patients despite systemic hemodynamic stabilization, and that infusion of dobutamine beneficially improves the microcirculation. The accompanying editorial by Dr. Ince greatly supported the conclusions made by the authors [2]. …