Assessments of skin and tongue microcirculation reveals major changes in porcine sepsis

Wester, Torjus; Häggblad, Erik; Awan, Z. A.; Barratt‐Due, Andreas; Kvernebo, Mari Skylstad; Halvorsen, Per Steinar; Mollnes, T. E.; Kvernebo, Knut

doi:10.1111/j.1475-097x.2010.00994.x

Cited by 17 publications

(20 citation statements)

References 29 publications

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“…We have reported pericapillary bleedings in the tongue of septic pigs four hours after injection of N. meningitides antigen [32]. Pericapillary bleedings was found in several skin locations of patient E1 (died on ECMO).…”

Section: Pericapillary Bleedingsmentioning

confidence: 88%

“…For analysis of flow velocity, each capillary of the five film sequences were visually scored into one of five groups from "no flow" (Category 0) to "brisk flow" (Category 4), and expressed in fractions (Fr = number of capillaries in each category/total number of capillaries) [32]. Based on the fractions of capillaries in each flow category, mean flow-categorial velocity was calculated in the following way:…”

Section: Computer Assisted Video Microscopy (Cavm)mentioning

confidence: 99%

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Skin microvascular morphology and hemodynamics during treatment with veno-arterial extra-corporeal membrane oxygenation

Wester

Awan

Kvernebo

et al. 2014

Clinical Hemorheology and Microcirculation

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OBJECTIVES: To explore the potentials of microcirculatory assessments for predicting outcome of patients treated with extra corporeal membrane oxygenation for cardiogenic shock. METHODS: Eight patients with acute cardiogenic shock treated with ECMO and eight healthy controls were examined with skin vital microscopy and laser Doppler perfusion measurements. RESULTS: Three patients died on ECMO (group 1). Five patients were successfully weaned off ECMO (group 2). Four patients were discharged from hospital and one died after successful weaning from bleeding complications. Patients surviving ECMO (group 2) had microcirculatory findings comparable with healthy controls. Patients in group 1 showed major skin microvascular pathology: pericapillary bleedings (n = 1), pericapillary dark haloes (n = 2) and capillary micro thrombi (n = 1). As compared with survivors they had lower functional capillary density (FCD) (n = 3), higher heterogeneity of functional capillary density (n = 3) and significantly reduced capillary mean flow-categorical velocity (n = 2). Laser Doppler measurements in group 1 had non-significant lower laser Doppler flux values as compared with survivors and controls. CONCLUSION: Skin microvascular pathology as detected with video microscopy (pericapillary bleedings or haloes, microthrombi/capillaries with "no flow", low FCD with high spatial distribution heterogeneity or low mean flow-categorial velocity) seems to be associated with poor prognosis.

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Section: Pericapillary Bleedingsmentioning

confidence: 88%

Section: Computer Assisted Video Microscopy (Cavm)mentioning

confidence: 99%

Skin microvascular morphology and hemodynamics during treatment with veno-arterial extra-corporeal membrane oxygenation

Wester

Awan

Kvernebo

et al. 2014

Clinical Hemorheology and Microcirculation

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“…The present study confirmed in accordance with previous studies that with the CAVM technique, it is possible to assess perfusion and vascular density in the nutritive papillary capillaries of the skin separately. 7,8,[14][15][16][17] Systemic circulatory failure can best be defined as lack of capacity of the circulatory system to deliver sufficient amounts of oxygen to the cells. 8 Capillary perfusion is regulated based on local metabolic needs in both the skin and in other tissues like in the brain.…”

Section: Discussionmentioning

confidence: 99%

“…With the CAVM technique, capillary morphology and physiology can be visualized and described according to size, shape, density, and blood flow velocity. 7,8,[14][15][16][17] Capillaries were defined as microvessels with a diameter <15 μm. Not all capillaries in a tissue are perfused at a given per millimeter line (c/mm).…”

Section: Cavmmentioning

confidence: 99%

Acute skin trauma induces hyperemia, but superficial papillary nutritive perfusion remains unchanged

et al. 2017

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“…Wester et al 31 investigated the changes of skin and sublingual microcirculatory changes in intravenous administration of heat-inactivated Neisseria meningitidis sepsis model on pigs. 200 minutes after sepsis was induced microcirculatory measurements were performed by laser Doppler and computer assisted video microscopy and they concluded that the degree of skin and sublingual microcirculatory impairment can be related to the severity of the sepsis.…”

Section: Skin Microcirculatory Changes Reflect Early the Circulatory mentioning

confidence: 99%

Skin microcirculatory changes reflect early the circulatory deterioration in a fulminant sepsis model in the pig

et al. 2015

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Intellectual and scientific content of the study, conception and design of the study, critical revision, final approval of the manuscript. ABSTRACT PURPOSE:In the pathophysiology of sepsis tissue perfusion dysfunction is a crucial driving force. Thus the early recognition is highly important. Concerning the early hours of bacteremia, and the systemic inflammatory response reaction leading to sepsis we aimed to investigate the micro-and macrocirculatory changes. METHODS:In 20 juvenile Hungahib pigs were anesthetized and the femoral artery and external jugular vein were prepared unilaterally and cannulated. For assisted ventilation tracheostomy was performed. In Sepsis group (n=11) live E. coli was intravenously administered (increasing concentration, 9.5x10^6 in 3h). In Control group (n=9) bacteria-free saline was administered at the same volume. Modified shock index (MSI), core and skin temperature, and skin microcirculation (laser Doppler) were measured before inducing bacteremia then hourly for 4h. RESULTS:In Control group parameters were stable, while six animals in the Sepsis group died before the 4 th hour. Core and skin temperature did not show significant alterations. In Sepsis group microcirculation showed a large impairment already by the 1st hour, while in MSI only by the 3rd hour. CONCLUSION:During bacteremia and the early phase of sepsis microcirculatory impairment can be detected soon, even hours before the deterioration in hemodynamic parameters in this porcine model.Key words: Bacteremia. Sepsis. Microcirculation. Hemodynamics. Shock. Models, Animal. Swine. Skin microcirculatory changes reflect early the circulatory deterioration in a fulminant sepsis model in the pig

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Assessments of skin and tongue microcirculation reveals major changes in porcine sepsis

Abstract: Capillary bleedings may be used as an early indication of severe sepsis. Examination of skin and tongue microcirculations may be used to characterize severity of sepsis and possibly to assess effect of treatment.

Cited by 17 publications

References 29 publications

Skin microvascular morphology and hemodynamics during treatment with veno-arterial extra-corporeal membrane oxygenation

Skin microvascular morphology and hemodynamics during treatment with veno-arterial extra-corporeal membrane oxygenation

Acute skin trauma induces hyperemia, but superficial papillary nutritive perfusion remains unchanged

Skin microcirculatory changes reflect early the circulatory deterioration in a fulminant sepsis model in the pig

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