Understanding the microcirculation in sepsis: still a long way to go...

Excerpt

In this issue of Intensive Care Medicine, Dyson et al. [1] present the results of an experimental study in which they evaluated the temporal changes in myocardial function and regional tissue oxygenation in peripheral and deep organs in a rat model of fecal peritonitis. They observed an early decline in regional tissue oxygenation, as assessed by measurement of tissue partial pressure of oxygen (tPO₂), especially in animals with low stroke volume at baseline. A stepwise increase in FiO₂ (oxygen challenge test) failed to increase the tPO₂ sufficiently during the early phase of sepsis, but the response to oxygen challenge improved in all organ beds except the kidney by 24 h. The strengths of this study [1] are that it provides information about cardiovascular function at both global and regional levels and that it evaluated regional perfusion simultaneously in several tissues—muscle, bladder, renal cortex, and liver. This multilevel approach would be expected to provide insight into the pathophysiology of sepsis and organ dysfunction. …