Effect of PGE1 on Altered Distribution of Regional Blood Flows in Hyperdynamic Sepsis

Exocrine pancreatic dysfunction in sepsis

“…Studies with animal models of sepsis show an impairment of the regional perfusion of the pancreas, which may be a crucial factor for the development of exocrine pancreatic dysfunction. Other work supports findings that blood flow is preferentially redistributed away from the pancreas in sepsis [6][7][8]. In hyperdynamic sepsis in sheep, increased blood flow to the heart, spleen, adrenal and small intestine was accompanied by decreased organ blood flow to the stomach, muscle and pancreas [5].…”

“…Recently, we described severe impairment of exocrine pancreatic function in critically ill patients with septic shock, which was not observed in nonseptic controls [2]. Several animal studies have shown a special vulnerability of pancreatic perfusion (3)(4)(5)(6)(7)(8), early during the course of sepsis [3], a finding that seems to be more pronounced than perfusion changes in other organs [6 -8]. Several animal studies have shown a special vulnerability of pancreatic perfusion (3)(4)(5)(6)(7)(8), early during the course of sepsis [3], a finding that seems to be more pronounced than perfusion changes in other organs [6 -8].…”

Cerebral Autoregulation is Influenced by Carbon Dioxide Levels in Patients with Septic Shock

“…There was no correlation between PaCO 2 and the initial VMCA. Fourteen patients (66%) had impaired cerebral autoregulation, including seven of the 14 patients (50%) with a PaCO 2 < 40 mmHg [28][29][30][31][32][33][34][35][36][37] and all seven of the patients with a PaCO 2 > 40 mmHg [41][42][43][44][45][46][47][48][49] (P = 0.046). Specifically, 4/9 (44%) patients with PaCO 2 < 35 mmHg, 7/9 (77%) with PaCO 2 between 35 and 42 mmHg, and 3/3 (100%) with PaCO 2 > 42 mmHg had impaired autoregulation.…”

“…Experimental investigations have demonstrated a wide range of CBF values during severe infections [36][37][38][39], probably because of the different models used. In human studies, CBF was in the lower range, suggesting a role of cerebral hypoperfusion in the development of SAE [40,41].…”

Brain Perfusion In Sepsis

“…In one study on dogs, CBF showed a 30% decrease within 15 min after endotoxin administration, while the arterial blood pressure was still not markedly changed [129]. Nevertheless, other studies also demonstrated that CBF was unchanged during sepsis induced in rats and sheep, while others reported an increased CBF [139,140,160,161]. Cerebrovascular resistances (CVR) initially decreased, then progressively increased to levels significantly higher than normal and were associated with the lowest CBF levels in the later stages of shock.…”