Microangiodynamic Abnormalities in Sepsis

  • R. Nevière
  • D. Mathieu
Conference paper
Part of the Yearbook of Intensive Care and Emergency Medicine book series (YEARBOOK, volume 1995)


Septic shock is characterized as a distributive form of circulatory failure [1]. Alteration in peripheral tone and cardiac function contribute to the cardiovascular manifestations of septic shock [2,3]. Cardiac output usually is increased or maintained by an increase in heart rate. Systemic vascular resistance is decreased reflecting decreased arteriolar and venular tone. In contrast, pulmonary vascular resistance frequently is increased with associated pulmonary hypertension. Hypoperfusion is marked by the accumulation of lactic acid despite less than maximal oxygen extraction.


Septic Shock Severe Sepsis Laser Doppler Flowmetry Reactive Hyperemia Capillary Blood Flow 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Parker MM, Parillo JE (1983) Septic shock, hemodynamics and pathogenesis. JAMA 250: 3324–3328PubMedCrossRefGoogle Scholar
  2. 2.
    Blain C, Anderson T, Pietras R, Gunnar R (1970) Immediate hemodynamic effects of gram-negative vs gram-positive bacteremia in man. Arch Intern Med 126: 260–265PubMedCrossRefGoogle Scholar
  3. 3.
    Groeneveld AJ, Bronsveld JW, Thijs L (1986) Hemodynamic determinants of mortality in human septic shock. Surgery 90: 140–152Google Scholar
  4. 4.
    Cryer H, Garrison W, Kaebnick H, Harris PD, Flint LM (1987) Skeletal microcirculatory responses to hyperdynamic Escherichia coli sepsis in anesthetized rats. Arch Surg 122: 86–92PubMedCrossRefGoogle Scholar
  5. 5.
    Dorio V, Whalen C, Naldi M, Fossion A, Juhmes J, Marcelle R (1989) Contribution of peripheral blood flow pooling to central hemodynamic disturbances during endotoxin insult in intact dogs. Crit Care Med 17: 1314–1319Google Scholar
  6. 6.
    Carrol G, Synder J (1982) Hyperdynamic severe intravascular sepsis depends on fluid administration in cyonomolgus monkey. Am J Physiol 243: R131–R141Google Scholar
  7. 7.
    Teule GJ, den Hollander W, Bronsveld W (1983) Effect of volume loading and dopamine on hemodynamics and red-cell redistribution in canine endotoxin shock. Circ Shock 10: 41–50PubMedGoogle Scholar
  8. 8.
    Whitworth PW, Cryer HM, Garrison RN, Baumgarten TE, Harris PD (1989) Hypoperfusion of the intestinal microcirculation without decreased cardiac output during live Escherichia coli sepsis in rats. Cir Shock 27: 111–122Google Scholar
  9. 9.
    Garrison RN, Ratcliffe DJ, Fry DE (1980) Hepatocellular function and nutrient blood flow in experimental peritonitis. Surgery 92: 713–719Google Scholar
  10. 10.
    Hartl WH, Gunther B, Inthorn D, Heberer G (1988) Reactive hyperemia in patients with septic conditions. Surgery 103: 440–444PubMedGoogle Scholar
  11. 11.
    Astiz ME, Tilly E, Rackow EC, Weil MH (1991) Peripheral vascular tone in sepsis. Chest 99: 1072–1075PubMedCrossRefGoogle Scholar
  12. 12.
    Hermansen L, Wachtlova M (1971) Capillary density of skeletal muscle in well trained and untrained men. J Appl Physiol 30: 860–863PubMedGoogle Scholar
  13. 13.
    Nicoll PA, Webb RL (1955) Vascular patterns and active vasomotion as determiners of flow through minute vessels. Angiology 6: 291–310PubMedCrossRefGoogle Scholar
  14. 14.
    Colantuoni A, Bertuglia S, Intaglietta M (1984) Quantitation of rhythmic diameter changes in arterial microcirculation. Am J Physiol 246: H508–H517PubMedGoogle Scholar
  15. 15.
    Fagrell B, Intaglietta M, Ostergren J (1980) Relative hematocrit in human skin capillaries and its relationship to capillary blood flow velocity. Microvasc Res 20: 327–335PubMedCrossRefGoogle Scholar
  16. 16.
    Intaglietta M (1981) Vasomotion activity, time-dependent fluid exchange and tissue pressure. Microcirc Res 21: 153–164Google Scholar
  17. 17.
    Meyer JU, Borgstrom P, Lindbom L, Intaglietta M (1988) Vasomotion patterns in skeletal muscle arterioles during changes in arterial pressure. Microvasc Res 35: 193–203PubMedCrossRefGoogle Scholar
  18. 18.
    Colantuoni A, Bertuglia S, Intaglietta M (1984) The effect of α- and β-adrenergic receptor agonists and antagonists and calcium entry blokers on the spontaneous vasomotion. Microvasc Res 28: 143–158PubMedCrossRefGoogle Scholar
  19. 19.
    Meyer JU, Lindbom L, Intaglietta M (1987) Coordinated diameter oscillations at arteriolar bifurcations in skeletal muscle. Am J Physiol 253: H568–H573PubMedGoogle Scholar
  20. 20.
    Lindbom L, Arfors KE (1985) Mechanism and site of control for variation in the number of perfused capillaries in skeletal muscle. Int J Microcirc Clin Exp 4: 19–30PubMedGoogle Scholar
  21. 21.
    Bertuglia S, Colantuoni A, Coppini G, Intaglietta (1991) Hypoxia- or hyperoxia-induced changes in arteriolar vasomotion in skeletal muscle microcirculation. Am J Physiol 260: H362–H372PubMedGoogle Scholar
  22. 22.
    Burton KS, Johnson PC (1972) Reactive hyperemia in individual capillaries of skeletal muscle. Am J Physiol 223: 517–524PubMedGoogle Scholar
  23. 23.
    Koller A, Kaley G (1990) Role of endothelium in reactive dilation of skeletal muscle arterioles. Am J Physiol 259: H1313–H1316PubMedGoogle Scholar
  24. 24.
    Ward ME, Magder SA, Hussain S (1993) Role of endothelium-derived factor in reactive hyperemia in canine diaphragm. Am J Physiol 74: 1606–1612Google Scholar
  25. 25.
    Sibbald WJ, Fox G, Martin C (1991) Abnormalities of vascular reactivity in the sepsis syndrome. Chest 100: 155S–159SPubMedGoogle Scholar
  26. 26.
    Dranzenovic R, Samsel RW, Wylam ME, Doerschule CM, Schumacker PT (1992) Regulation of perfused capillary density in canine intestinal mucosa during endotoxemia. J Appl Physiol 72: 259–265CrossRefGoogle Scholar
  27. 27.
    Boczkowski J, Vicaut E, Aubier M (1992) In vivo effects of Escherichia coli endotoxemia on diaphragmatic microcirculation in rats. J Appl Physiol 72: 2219–2224PubMedGoogle Scholar
  28. 28.
    Gutierrez G, Lund N, Palizas F (1991) Rabbit skeletal muscle PO2 during hypodynamie sepsis. Chest 99: 224–229PubMedCrossRefGoogle Scholar
  29. 29.
    Vallet B, Lund N, Curtis SE, Kelly D, Cain SM (1994) Gut and muscle tissue PO2 in endotoxemic dogs during shock and resuscitation. J Appl Physiol 76: 793–800PubMedGoogle Scholar
  30. 30.
    Whitney RJ (1953) The measurement of volume changes in human limbs. J Physiol 121: 1–27PubMedGoogle Scholar
  31. 31.
    Gamble J, Gartside IB, Merrithew S (1989) The time course of the vascular compliance component of human lower limbs during venous occlusion Mercury-in-rubber strain gauge (MSG) plethysmography. Int J Microcirc Clin Exp 9: 123P (Abst)Google Scholar
  32. 32.
    Michel CC, Moyses C (1987) The measurement of fluid filtration in human limbs. In: Tooke J, Smaje LH (eds) Clinical investigation of the microcirculation. Maritus Nijhoff. Boston, pp 103–126CrossRefGoogle Scholar
  33. 33.
    Lang CH, Bagby Gj, Ferguson JL (1984) Cardiac output and redistribution of organ blood flow in hyperdynamic sepsis. Am J Physiol 246: R331–R337PubMedGoogle Scholar
  34. 34.
    Theuer CJ, Wilson MA, Steeb GD, Garrison RN (1993) Microvascular vasoconstriction and mucosal hypoperfusion of the rat small intestine during bacteremia. Circ Shock 40: 61–68PubMedGoogle Scholar
  35. 35.
    Bonner RF, Clem TR, Bowen PD (1981) Laser-Doppler continuous real-time monitor of pulsatile and mean blood flow in tissue microcirculation. In: Chen SH, Chu B, Nossal R (eds) Scattering techniques applied to supramolecular and non-equilibrium systems. Plenum Press, New York, pp 685–701Google Scholar
  36. 36.
    Bonner R, Nossal R (1981) Model for laser Doppler measurements of blood flow in tissue. Appl Optics 20: 2097–2107CrossRefGoogle Scholar
  37. 37.
    Stern MD (1975) In vivo evaluation of microcirculation by coherent light scattering. Nature 254: 56–58PubMedCrossRefGoogle Scholar
  38. 38.
    Tahmoush AJ, Bowen PD, Bonner RF, Mancini TJ, KingEngei W (1983) Laser Doppler blood flow studies during pen muscle biopsy in patients with neuromuscular diseases. Neurology 33: 547–551PubMedGoogle Scholar
  39. 39.
    Tooke JE, Ostergren J, Fagrell B (1983) Synchronous assessment of human microcirculation by laser Doppler flometry and dynamic capillaroscopy. Int J Microcircul Clin Exp 2: 277–284Google Scholar
  40. 40.
    Mechler F, Mastaglia FL, Haggith J (1980) Adrenergic receptor responses of vascular smooth muscle in Becker dystrophy: A muscle blood flow study using the 133Xe clearance method. J Neurol Sci 46: 291–302PubMedCrossRefGoogle Scholar
  41. 41.
    Neviere R, Mathieu D, Chagnon JL, Wattel F (1994) Skeletal muscle microvascular response to severe sepsis: Effects of O2 delivery increase on reactive hyperemia. Crit Care Med 22: A110 (Abst)CrossRefGoogle Scholar
  42. 42.
    Finley RJ, Duff JH, Holliday RL, Hones RL, Marchuk JB (1975) Capillary blood flow in human sepsis. Surgery 78: 87–94PubMedGoogle Scholar
  43. 43.
    Ellsworth ML, Goldfarb RD, Alexander RS, Bell DR, Powers SR (1981) Microembolization-induced oxygen utilization impairement in the canine gracilis muscle. Adv Shock Res 5: 89–99PubMedGoogle Scholar
  44. 44.
    Maynard N, Bihari D, Beale R, et al (1993) Assessement of splanchnic tonometry in patients with acute circulatory failure. JAMA 270: 1203–1210PubMedCrossRefGoogle Scholar
  45. 45.
    Kvietys PR, Shepherd AP, Granger DN (1985) Laser-Doppler, H2 clearance, and microsphere estimates of mucosal blood flow. Am J Physiol 249: G221–G227PubMedGoogle Scholar
  46. 46.
    Kvernebo K, Lunde OC, Larsen S (1986) Human gastric blood circulation evaluated by endoscopic laser Doppler flowmetry. Scand J Gastroenterol 21: 685–692PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1995

Authors and Affiliations

  • R. Nevière
  • D. Mathieu

There are no affiliations available

Personalised recommendations