Laser speckle contrast imaging for assessing microcirculatory changes in multiple splanchnic organs and the gracilis muscle during hemorrhagic shock and fluid resuscitation

Wu, Chun-Yu; Yeh, Yu-Chang; Chien, Chiang-Ting; Chao, Anne; Sun, Wei‐Zen; Cheng, Ya-Jung

doi:10.1016/j.mvr.2015.06.003

Cited by 19 publications

(13 citation statements)

References 25 publications

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“…Although some studies showed a decrease of microcirculatory blood flow during HS, we failed to detect significant changes in local blood flow during HS in this study. However, these other studies used different animal (dogs or rats) and shock models (HS for 45 min with MAP of 40 mmHg, and HS for 30 min with total blood loss of 30 mL/kg/BW). In our analysis, a standardised porcine HS model was applied, as the porcine physiology closely mimics the human one.…”

Section: Discussioncontrasting

confidence: 77%

“…However, the microcirculatory blood flow was elevated over the observation period of 72 h. Our results are in line with previous publications. Several studies have also shown that after resuscitation the local microcirculation disturbance appears to last for a longer period . This might be due to the post‐traumatic local and systemic increase of inflammation mediators, such as IL‐6 (Interleukin), IL‐8, IL‐10, HMGB 1 (High mobility group box 1) and TNF‐a (tumor necrosis factor alpha) .…”

Section: Discussionmentioning

confidence: 99%

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Analysis of skeletal muscle microcirculation in a porcine polytrauma model with haemorrhagic shock

Qiao

Horst

Teuben

et al. 2018

Journal Orthopaedic Research

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Polytraumatised patients with haemorrhagic shock are prone to develop systemic complications, such as SIRS (systemic inflammatory response syndrome), ARDS (acute respiratory distress syndrome) and MOF (multiple organ failure). The pathomechanism of severe complications following trauma is multifactorial, and it is believed that microcirculatory dysfunction plays an important role. The aim of this study was to determine the changes in the microcirculation in musculature over time during shock and subsequent resuscitation in a porcine model of haemorrhagic shock and polytrauma. Twelve pigs (German Landrace) underwent femur fracture, liver laceration, blunt chest trauma, and haemorrhagic shock under standard anaesthesia and intensive care monitoring. Microcirculation data were measured from the vastus lateralis muscle using a combined white light spectrometry and laser spectroscopy system every 15 min during the shock and resuscitation period, and at 24, 48, and 72 h. Oxygen delivery and oxygen consumption were calculated and compared to baseline. The relative haemoglobin, local oxygen consumption, and saturation values in the microcirculation were observed significantly lower during shock, however, no changes in the microcirculatory blood flow and microcirculatory oxygen delivery were observed. After resuscitation, the microcirculatory blood flow and relative haemoglobin increased and remained elevated during the whole observation period (72 h). In this study, we observed changes in microcirculation during the trauma and shock phases. Furthermore, we also measured persistent dysfunction of the microcirculation over the observation period of 3 days after resuscitation and haemorrhagic shock. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1377-1382, 2018.

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Section: Discussioncontrasting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Analysis of skeletal muscle microcirculation in a porcine polytrauma model with haemorrhagic shock

Qiao

Horst

Teuben

et al. 2018

Journal Orthopaedic Research

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“…In rodent models of hemorrhagic shock, evidence suggests that resuscitation with colloids as well as balanced crystalloid solutions may be more advantageous than 0.9% sodium chloride solution (saline). [7][8][9] However, saline is still the most commonly used resuscitation fluid. 10 The microvascular effects of modern colloid solutions compared with saline with respect to microcirculation and hemodynamic coherence have not been sufficiently investigated in the setting of acute hemorrhagic hypovolemia.…”

Section: What This Article Tells Us That Is Newmentioning

confidence: 99%

Resuscitation with Hydroxyethyl Starch Maintains Hemodynamic Coherence in Ovine Hemorrhagic Shock

et al. 2020

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Background: Fluid resuscitation in hemorrhagic shock aims to restore hemodynamics and repair altered microcirculation. Hemodynamic coherence is the concordant performance of macro-and microcirculation. The present study on fluid therapy in hemorrhagic shock hypothesized that the choice of fluid (0.9% sodium chloride [saline group] or balanced 6% hydroxyethyl starch 130/0.4 [hydroxyethyl starch group]) impacts on hemodynamic coherence. Methods: After instrumentation, 10 sheep were bled up to 30 ml/kg body weight of blood stopping at a mean arterial pressure of 30 mmHg to establish hemorrhagic shock. To reestablish baseline mean arterial pressure, they received either saline or hydroxyethyl starch (each n = 5). Hemodynamic coherence was assessed by comparison of changes in mean arterial pressure and both perfused vessel density and microvascular flow index. results: Bleeding of 23 ml/kg blood [21; 30] (median [25th; 75th percentile]) in the saline group and 24 ml/kg [22; 25] (P = 0.916) in the hydroxyethyl starch group led to hemorrhagic shock. Fluid resuscitation reestablished baseline mean arterial pressure in all sheep of the hydroxyethyl starch group and in one sheep of the saline group. In the saline group 4,980 ml [3,312; 5,700] and in the hydroxyethyl starch group 610 ml [489; 615] of fluid were needed (P = 0.009). In hemorrhagic shock perfused vessel density (saline from 100% to 83% [49; 86]; hydroxyethyl starch from 100% to 74% [61; 80]) and microvascular flow index (saline from 3.1 [2.5; 3.3] to 2.0 [1.6; 2.3]; hydroxyethyl starch from 2.9 [2.9; 3.1] to 2.5 [2.3; 2.7]) decreased in both groups. After resuscitation both variables improved in the hydroxyethyl starch group (perfused vessel density: 125% [120; 147]; microvascular flow index: 3.4 [3.2; 3.5]), whereas in the saline group perfused vessel density further decreased (64% [62; 79]) and microvascular flow index increased less than in the hydroxyethyl starch group (2.7 [2.4; 2.8]; both P < 0.001 for saline vs. hydroxyethyl starch). Conclusions: Resuscitation with hydroxyethyl starch maintained coherence in hemorrhagic shock. In contrast, saline only improved macro-but not microcirculation. Hemodynamic coherence might be influenced by the choice of resuscitation fluid.

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“…Several different techniques and anatomical locations were used to determine microcirculatory parameters, as summarised in Table 3. Five studies (41,56,69,88,89) examined the microcirculation in multiple regions, and the remainder studied only one anatomical location. One study conducted haemorheological analysis externally (from blood samples) without specific anatomical location (92).…”

Section: Microcirculatory Monitoring Techniquesmentioning

confidence: 99%

Searching For the Optimal Fluid to Restore Microcirculatory Flow Dynamics After Haemorrhagic Shock

Naumann

Beaven

Dretzke

et al. 2016

Shock

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Laser speckle contrast imaging for assessing microcirculatory changes in multiple splanchnic organs and the gracilis muscle during hemorrhagic shock and fluid resuscitation

Cited by 19 publications

References 25 publications

Analysis of skeletal muscle microcirculation in a porcine polytrauma model with haemorrhagic shock

Analysis of skeletal muscle microcirculation in a porcine polytrauma model with haemorrhagic shock

Resuscitation with Hydroxyethyl Starch Maintains Hemodynamic Coherence in Ovine Hemorrhagic Shock

Searching For the Optimal Fluid to Restore Microcirculatory Flow Dynamics After Haemorrhagic Shock

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