The Microcirculatory Effects of Endotoxin Shock as Evaluated by Effects on Interstitial Fluid Pressure

Border, John R.; Heyden, William C.; Jacobs, Rae R.; Hopkinson, Briar R.; Schenk, Worthington G.

doi:10.1001/archsurg.1970.01340260188028

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…In an experimental rat model, injection of LPS reduced interstitial pressure and contributed to oedema formation with extravasation of I-125-marked albumin [ 57 ]. A comparable reduction was previously observed in a model of endotoxic shock in dogs, with an immediate reduction in interstitial pressure of up to 9 mmHg [ 58 ].…”

Section: Interstitial Pressure (And Transcapillary Flow) Regulation D...supporting

confidence: 84%

“…As mentioned earlier, endotoxic shock was characterized by a marked, although transient lowering of P if (increasing V i due to capillary filtration explains the return to pre-shock values). However, in hemorrhagic shock and with the isolated perfusion of catecholamines, P if was also lowered, but in a constant and dose-dependent manner [ 58 ]. This was predicted, according to authors, by the Starling principles, as the vascular volume is decreased by vasopressors (thereby increasing relative V i ).…”

Section: Interstitial Pressure (And Transcapillary Flow) Regulation D...mentioning

confidence: 99%

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Role of the interstitium during septic shock: a key to the understanding of fluid dynamics?

Dargent,

Dumargne,

Labruyère

et al. 2023

j intensive care

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Background While not traditionally included in the conceptual understanding of circulation, the interstitium plays a critical role in maintaining fluid homeostasis. Fluid balance regulation is a critical aspect of septic shock, with a well-known association between fluid balance and outcome. The regulation of transcapillary flow is the first key to understand fluid homeostasis during sepsis. Main text Capillary permeability is increased during sepsis, and was classically considered to be necessary and sufficient to explain the increase of capillary filtration during inflammation. However, on the other side of the endothelial wall, the interstitium may play an even greater role to drive capillary leak. Indeed, the interstitial extracellular matrix forms a complex gel-like structure embedded in a collagen skeleton, and has the ability to directly attract intravascular fluid by decreasing its hydrostatic pressure. Thus, interstitium is not a mere passive reservoir, as was long thought, but is probably major determinant of fluid balance regulation during sepsis. Up to this date though, the role of the interstitium during sepsis and septic shock has been largely overlooked. A comprehensive vision of the interstitium may enlight our understanding of septic shock pathophysiology. Overall, we have identified five potential intersections between septic shock pathophysiology and the interstitium: 1. increase of oedema formation, interacting with organ function and metabolites diffusion; 2. interstitial pressure regulation, increasing transcapillary flow; 3. alteration of the extracellular matrix; 4. interstitial secretion of inflammatory mediators; 5. decrease of lymphatic outflow. Conclusions We aimed at reviewing the literature and summarizing the current knowledge along these specific axes, as well as methodological aspects related to interstitium exploration.

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Section: Interstitial Pressure (And Transcapillary Flow) Regulation D...supporting

confidence: 84%

Section: Interstitial Pressure (And Transcapillary Flow) Regulation D...mentioning

confidence: 99%

Role of the interstitium during septic shock: a key to the understanding of fluid dynamics?

Dargent,

Dumargne,

Labruyère

et al. 2023

j intensive care

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“…The pressure in SC showed a marked decrease as the blood pressure increased. BORDER et al (1970) also observed a pressure fall in SC after adrenalin or noradrenalin administration. In the present study, two troughs were often observed in the capsular pressure response.…”

Section: Discussionmentioning

confidence: 78%

Effect of Vasoactive Drugs on the Fluid Pressure of Capsules Implanted Into Dog Brain, Subcutaneous Tissue and Muscle

Matsuo

Mihara

1974

Jpn.J.Physiol

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Perforated capsules were implanted into the brain parenchyma, subcutaneous tissue, and muscle (denoted BC, SC, and MC, respectively) of dogs. After implantation, tissue grew and fluid was retained within the capsules. The effects of vasoactive drugs on the intracapsular fluid and cerebrospinal fluid (CSF) pressures were observed. Adrenalin and noradrenalin were used as pressor agents, and acetylcholine, isoproterenol, and isoxsuprine as depressor agents, together with certain other drugs. The following results were obtained: 1. The observed changes in CSF and intracapsular fluid pressures were largely dependent on the induced blood pressure changes following drug administration. 2. The CSF pressure was increased by both the pressor agents and depressor agents. 3. The SC and MC pressures were decreased by the pressor agents and generally increased by the depressor agents. 4. BC pressure was increased by the pressor agents and decreased mostly by isoproterenol, affected rather variably by isoxsuprine, while there was an initial decrease and subsequent increase with acetylcholine. 5. The pattern of these pressure responses in the BC fluid was clearly different from that in the CSF. The direction of pressure fluctuation in BC was opposite to that in both SC and MC. 6. Possible mechanisms for these capsular and CSF pressure fluctuations are discussed.

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“…De même, l'inflammation « septique » semble provoquer les mêmes effets : dans une étude expérimentale chez des rats, le LPS à différentes concentrations diminuait la pression interstitielle et contribuait à la formation d'oedèmes (28). Une diminution similaire avait déjà été retrouvée dans un autre modèle d'endotoxémie (29). Dans un modèle de choc endotoxinique chez des chiens, une diminution rapide de la pression interstitielle jusqu'à 9 mmHg était observée (29).…”

Section: Volume Et Pression Interstitielsunclassified

“…Une diminution similaire avait déjà été retrouvée dans un autre modèle d'endotoxémie (29). Dans un modèle de choc endotoxinique chez des chiens, une diminution rapide de la pression interstitielle jusqu'à 9 mmHg était observée (29).…”

Section: Volume Et Pression Interstitielsunclassified

Au-delà de l’œdème : l’interstitium comme chaînon manquant entre macro- et microcirculation au cours du sepsis

Jacquier

Bonnot²,

Labruyère

et al. 2022

Méd. Intensive Réa.

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Au cours du choc septique, le remplissage vasculaire corrige l’hypovolémie liée à la fuite capillaire, responsable de l’état de choc et de l’apparition progressive d’œdèmes généralisés. La fuite capillaire a longtemps été considérée comme principalement due à des modifications de l’endothélium vasculaire et du glycocalyx. Or, le rôle central du tissu interstitiel dans la régulation des échanges de fluides au cours de l’inflammation est décrit dans un nombre croissant d’études. En effet, la matrice extracellulaire (MEC) interstitielle permet de réguler finement la pression hydrostatique interstitielle par le biais de l’interaction des fibroblastes avec les fibres de collagène de la MEC. Sous l’action des médiateurs pro-inflammatoires lors d’une inflammation localisée, cette tension est relâchée brutalement ce qui entraine une baisse de la pression interstitielle, potentialisant de fait la formation d’œdème. Le rôle de l’interstitium au cours du sepsis est encore très mal connu, mais de nombreuses données semblent indiquer un rôle majeur dans la régulation de la filtration capillaire. L’interstitium a donc probablement un impact significatif dans la régulation de la balance hydrosodée, qui est un des enjeux fondamentaux pour la prise en charge du sepsis.

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The Microcirculatory Effects of Endotoxin Shock as Evaluated by Effects on Interstitial Fluid Pressure

Cited by 4 publications

References 11 publications

Role of the interstitium during septic shock: a key to the understanding of fluid dynamics?

Role of the interstitium during septic shock: a key to the understanding of fluid dynamics?

Effect of Vasoactive Drugs on the Fluid Pressure of Capsules Implanted Into Dog Brain, Subcutaneous Tissue and Muscle

Au-delà de l’œdème : l’interstitium comme chaînon manquant entre macro- et microcirculation au cours du sepsis

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