Severe abnormalities in microvascular perfused vessel density are associated to organ dysfunctions and mortality and can be predicted by hyperlactatemia and norepinephrine requirements in septic shock patients

Hernández, Glenn; Boerma, E. Christiaan; Dubin, Arnaldo; Bruhn, Alejandro; Koopmans, Matty; Edul, Vanina Siham Kanoore; Ruíz, Carolina; Castro, Ricardo; Pozo, Mario Omar; Pedreros, Cesar; Veas, Enrique; Fuentealba, Andrea; Kattan, Eduardo; Rovegno, Maximiliano; İnce, Can

doi:10.1016/j.jcrc.2012.11.022

Cited by 82 publications

(60 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Almost all studies performed in septic shock found some degree of alteration of the sublingual microcirculation, leading to the question of when are these derangements clinically relevant [4]. The prognostic significance was brought almost exclusively by the lowest quartiles of severity of alteration of sublingual microcirculation [3,4] However, severe microcirculatory derangements most often coexist with other markers of severity such as hyperlactatemia, organ dysfunctions and high vasopressor requirements, even if cardiac output and blood pressure have been corrected [4].…”

Section: When Can Microcirculatory Derangements Be Considered Clinicamentioning

confidence: 99%

“…The prognostic significance was brought almost exclusively by the lowest quartiles of severity of alteration of sublingual microcirculation [3,4] However, severe microcirculatory derangements most often coexist with other markers of severity such as hyperlactatemia, organ dysfunctions and high vasopressor requirements, even if cardiac output and blood pressure have been corrected [4]. In other words, isolated severe sublingual microcirculatory dysfunction appears to be an uncommon event.…”

Section: When Can Microcirculatory Derangements Be Considered Clinicamentioning

confidence: 99%

“…Since the landmark paper by De Backer et al [1], numerous studies have addressed microcirculatory dysfunction in septic shock, established its pathophysiological relevance, and demonstrated the prognostic impact of persistent abnormalities [2][3][4][5]. Sublingual microcirculation, which is easy to access with video-microscopic techniques, is the most frequently explored territory in humans.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is the macrocirculation really dissociated from the microcirculation in septic shock?

Hernández

Teboul

2016

Intensive Care Med

View full text Add to dashboard Cite

Section: When Can Microcirculatory Derangements Be Considered Clinicamentioning

confidence: 99%

Section: When Can Microcirculatory Derangements Be Considered Clinicamentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Is the macrocirculation really dissociated from the microcirculation in septic shock?

Hernández

Teboul

2016

Intensive Care Med

View full text Add to dashboard Cite

“…Although mortality has been reported to be decreased due to the progress in therapy for septic shock [2,3], microcirculation abnormalities can still be present and contribute to hypoperfusion [4]. Microvascular dysfunction is associated with organ dysfunction and mortality [5,6]; moreover, early improvement in the microcirculation during resuscitation is associated with reduced organ failure [7]. Therefore, therapeutic strategies aimed at improving the microcirculation are warranted to mitigate hypoperfusion and organ failure.…”

Section: Introductionmentioning

confidence: 99%

A high mean arterial pressure target is associated with improved microcirculation in septic shock patients with previous hypertension: A prospective open-label study

Yang

Qiu

2015

Journal of Critical Care

View full text Add to dashboard Cite

show abstract

“…This nonphysiological and inexpedient shutdown of capillaries leads to an increased diffusion distance for oxygen [18]. A decreased vessel density has also been found in noncooled septic adults, children and newborns, and has been suggested to be prognostic for the outcome [13,14,19,20]. …”

Section: Discussionmentioning

confidence: 99%

Cooling Effect on Skin Microcirculation in Asphyxiated Newborn Infants with Increased C-Reactive Protein

et al. 2016

View full text Add to dashboard Cite

Background: Therapeutic hypothermia is presumed to suppress inflammatory processes after perinatal asphyxia. In a previous study of neonatal hypoxic-ischemic encephalopathy (HIE) we found altered skin microcirculation in about a third of the infants after rewarming. We speculated whether this could be linked to increased inflammatory responses, such as high C-reactive protein (CRP). The present study further explored this question. Objective: The aim of this study was to explore the differences in skin microcirculation and its oxygen delivery ability during cooling and after rewarming in HIE infants with or without high CRP. Methods: A previously studied population of 28 HIE infants was divided into two subgroups depending on low or high CRP (repeated values above 30 mg/l for more than 24 h). The differences between the two groups regarding laser Doppler perfusion measurements (LDPMs), computer-assisted video microscopy and diffuse reflectance spectroscopies during cooling on days 1 and 3 and after rewarming on day 4 were assessed. Results: After rewarming, infants with high CRP showed significantly higher skin LDPM perfusion, lower functional vessel density and larger heterogeneity of capillary flow velocities as compared to infants with low CRP, while no such differences were found during cooling. Conclusion: Skin microcirculatory responses differed significantly after rewarming, but not during cooling, between asphyxiated neonates with or without high CRP. We speculate whether cooling influences the inflammatory skin microcirculatory response and the ability of oxygen delivery to the cells. Further studies are needed to investigate this as well as its applicability to other vascular beds in the body.

show abstract

Severe abnormalities in microvascular perfused vessel density are associated to organ dysfunctions and mortality and can be predicted by hyperlactatemia and norepinephrine requirements in septic shock patients

Cited by 82 publications

References 35 publications

Is the macrocirculation really dissociated from the microcirculation in septic shock?

Is the macrocirculation really dissociated from the microcirculation in septic shock?

A high mean arterial pressure target is associated with improved microcirculation in septic shock patients with previous hypertension: A prospective open-label study

Cooling Effect on Skin Microcirculation in Asphyxiated Newborn Infants with Increased C-Reactive Protein

Contact Info

Product

Resources

About