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Critical Care
Published in: Critical Care 3/2012

Open Access 01-06-2012 | Research

Early course of microcirculatory perfusion in eye and digestive tract during hypodynamic sepsis

Authors: Andrius Pranskunas, Vidas Pilvinis, Zilvinas Dambrauskas, Renata Rasimaviciute, Rita Planciuniene, Paulius Dobozinskas, Vincentas Veikutis, Dinas Vaitkaitis, E Christiaan Boerma

Published in: Critical Care | Issue 3/2012

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Abstract

Introduction

The aim of the study was to evaluate and compare the microcirculatory perfusion during experimental sepsis in different potentially available parts of the body, such as sublingual mucosa, conjunctiva of the eye, and mucosa of jejunum and rectum.

Methods

Pigs were randomly assigned to sepsis (n = 9) and sham (n = 4) groups. The sepsis group received a fixed dose of live Escherichia coli infusion over a 1-hour period (1.8 × 109/kg colony-forming units). Animals were observed 5 hours after the start of E. coli infusion. In addition to systemic hemodynamic assessment, we performed conjunctival, sublingual, jejunal, and rectal evaluation of microcirculation by using Sidestream Dark Field (SDF) videomicroscopy at the same time points: at baseline, and at 3 and 5 hours after the start of live E. coli infusion. Assessment of microcirculatory parameters of convective oxygen transport (microvascular flow index (MFI) and proportion of perfused vessels (PPV)), and diffusion distance (perfused vessel density (PVD) and total vessel density (TVD)) was done by using a semiquantitative method.

Results

Infusion of E. coli resulted in a hypodynamic state of sepsis associated with low cardiac output and increased systemic vascular resistance despite fluid administration. Significant decreases in MFI and PPV of small vessels were observed in sublingual, conjunctival, jejunal, and rectal locations 3 and 5 hours after the start of E. coli infusion in comparison with baseline variables. Correlation between sublingual and conjunctival (r = 0.80; P = 0.036), sublingual and jejunal (r = 0.80; P = 0.044), and sublingual and rectal (r = 0.79; P = 0.03) MFI was observed 3 hours after onset of sepsis. However, this strong correlation between the sublingual and other regions disappeared 5 hours after the start of E. coli infusion. Overall, the sublingual mucosa exhibited the most-pronounced alterations of microcirculatory flow in comparison with conjunctival, jejunal, and rectal microvasculature (P < 0.05).

Conclusions

In this pig model, a time-dependent correlation exists between sublingual and microvascular beds during the course of a hypodynamic state of sepsis.
Appendix
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Metadata
Title
Early course of microcirculatory perfusion in eye and digestive tract during hypodynamic sepsis
Authors
Andrius Pranskunas
Vidas Pilvinis
Zilvinas Dambrauskas
Renata Rasimaviciute
Rita Planciuniene
Paulius Dobozinskas
Vincentas Veikutis
Dinas Vaitkaitis
E Christiaan Boerma
Publication date
01-06-2012
Publisher
BioMed Central
Published in
Critical Care / Issue 3/2012
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc11341

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