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| The relationship between sublingual and mesenteric microcirculation in a porcine model of sepsis |
| Liu Wei, Duan Mei-li, Weng Yi-bing, Shen Jia-wei, Zhang Lei, Zhen Gen-shen, Li Ang |
| Center of Emergency and Critical Care Medicine EICU, Beijing Luhe Hospital, Capital Medical University, Beijing 101100, China |
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Abstract 〓Objective〓〖WTBZ〗To determine the relationship between sublingual and mesenteric microcirculatory perfusion, and the relationship between microcirculation and systemic hemodynamic. 〖JP2〗〖WTHZ〗Methods〓〖WTBZ〗Twelve fasted, anesthetized pigs were randomized to a sham group (n=6) and a sepsis group (n=6) in which peritonitis was induced by injection of autologous feces into the peritoneal. The sublingual and mesenteric microcirculations were simultaneously assessed at 0, 4, 8，12 h, before the animal have a septic shock, and at 2 h intervals, for up to 4 h after the animal have a septic shock (MAP≤65 mm Hg) with a sidestream dark field(SDF) imaging device. In both regions total vessel density (TVD), perfusing vessel density (PVD), proportion of perfused vessels (PPV), and microvascular flow index (MFI) were measured. Arterial partial pressure of oxygen, carbon dioxide partial pressure and blood lactate were monitored at the same time points, hemodynamic parameters, including heart rate(HR), mean arterial pressure (MAP), cardiac index (CI). 〖WTHZ〗Results〓〖WTBZ〗①Eight hours later, both sublingual and mesenteric PPV and MFI were significantly lower in sepsis pigs compared with basal levels(＞30%, P＜0.05); when animals developed to septic shock sublingual and mesenteric PPV and MFI decreased to a more lower level(＞50%, P＜0.05). However, PVD did not show significance until the 12th hour of septic modeling. TVD had no significant difference during the experiment.②Sublingual microcirculations showed a significant correlation with mesenteric microcirculations〖JP〗(MFI: r=0.60, P＜0.01; TVD: r=0.284, P＜0.01; PVD: r=0.492, P＜0.01; PPV: r=0.705, P＜0.01). ③Both sublingual and mesenteric microcirculations (PPV, MFI) showed a significant correlation with CI before septic shock, however the correlation failed after septic shock. When the MAP was above 100 mm Hg at the 12th hour the microcirculation (PPV,MFI) has significantly decreased at the 8th hour. 〖WTHZ〗Conclusion〓〖WTBZ〗①The sublingual and mesenteric microcirculations are rapidly and significantly altered in this septic model. These microcirculatory alterations are of similar severity and follow a similar time course. ②Sublingual microcirculations show a significant correlation with mesenteric microcirculations. Splanchnic microcirculation could be assessed by monitoring the sublingual microcirculation. ③Microcirculatory alterations precede mean arterial pressure disturbances.
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Received: 28 March 2017
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Corresponding Authors:
Li Ang, E-mail: liang_bjfh68@hotmail.com
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