0732. Sequential changes in the pattern of liver architecture in the acute phase of severe sepsis under the vision of videomicroscopy. Experimental study
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KeywordsSevere Sepsis Hepatic Lobule Blood Flow Limitation Dilate Sinusoid Microcirculatory Dysfunction
Therapeutic grounded in the specific state of microcirculatory dysfunction in septic patients is still an impediment due to technological limitations, and consequently there is little knowledge about the pathophysiological microcirculatory dynamics associated with organ failure.
Investigate the pattern of hepatic microcirculation during the golden period of therapy in severe sepsis.
Wistar rats underwent severe sepsis (iv. E. coli 2x109 CFU, DL70-80 in 26 hours3) and under general anesthesia the dynamics of microcirculatory at the liver surface was monitored by SDF1,2 at T0,T30min and T1-T6 hours and the tissue injury by histology (T0,T2h,T6h). Saline injection was used as control.
These findings suggested that the process involved in the genesis of hepatic failure in sepsis could be due to the cyclical repetition of the event: sinusoidal microcirculatory dysfunction - cytopathic hypoxia of the hepatocytes - edema of the columns of hepatocytes - compression of sinusoids - hepatic lobules dysfunction.
The genesis of liver failure in severe sepsis appears to depend on the repetitive cyclic of sinusoidal dysfunction and subsequent adjacent hepatocytes that in turn exacerbates the progression of the liver dysfunction, thus suggesting the conjoined participation of both factors in the genesis of the solid organ dysfunction.
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