Abstract
Attempts to effectively intervene on sepsis mechanisms by correcting the dysfunction and the pathological activation of microcirculation—and, therefore, of the endothelium—represent the most fascinating challenge for physicians and researchers dealing with these patients. However, to date there is no evidence that specific therapeutic strategies aimed at controlling micro-vascular endothelium may, in patients suffering septic shock, provide clinical benefits and increased survival probability. As for oedema and sepsis, the news is even worse: we know that the formation of oedema is a constant in patients with sepsis, we know that the development of oedema can cause the deterioration of organ functioning due to deficient perfusion and cellular oxygenation and we know that, unfortunately, today there is no effective drug nor winning strategy.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Parodi O, De Chiara B, Campolo J, Sedda V, Roubina E (2006) Endothelial dysfunction and oxidative stress in sepsis. G Ital Nefrol 36:69–73
Dejana E, Mantovani A (1993) Anatomia funzionale. In: Dejana E, Mantovani A (eds) Fisiopatologia dell’endotelio vascolare. Piccin, Padova, pp 7–21
Bazzoni G, Dejana E, Mantovani A (2007) Funzioni specifiche delle cellule endoteliali. In: Bazzoni G, Dejana E, Mantovani A L (eds) ’Endotelio, fisiopatologia, basi molecolari, implicazioni terapeutiche. Piccin, Padova, pp 15–23
Dejana E, Mantovani A (1993) Regolazione della coagulazione e della fibrinolisi. In: Dejana E, Mantovani A (eds) Fisiopatologia dell’endotelio vascolare. Piccin, Padova, pp 32–40
Levi M, Van Der Poll T, Schultz M (2012) New insights into pathways that determine the link between infection and thrombosis. Neth J Med 70:114–120
Calò L, Semplicini A (1998) Funzione dell’endotelio normale. In: Calò L, Semplicini A L (eds)’Endotelio vascolare aspetti morfofunzionali fisiopatologici e terapeutici. Piccin, Padova, pp 19–39
Bazzoni G, Dejana E, Mantovani A (2007) Anatomia funzionale caratteristiche generali. In: Bazzoni G, Dejana E, Mantovani A L (eds)’Endotelio, fisiopatologia, basi molecolari, implicazioni terapeutiche. Piccin, Padova, pp 1–13
Berne RM, Levy MN (1995) La microcircolazione e i linfatici. In: Berne RM, Levy MN (eds) Fisiologia. Casa editrice Ambrosiana, Milano, pp 498–10
Huxley VH, Scallan J (2011) Lymphatic fluid: exchange mechanism and regulation. J Physiol 589:2935–2943
Schnoor M, Lai FPL, Zarbock A, Klaver R, Polaschegg C, Schulte D, Weich A, Oelkers JM, Rottner K, Vestweber D (2011) Cortactin deficiency is associated with reduced neutrophil recruitment but increased vascular permeability in vivo. J Exp Med 208:1721–1735
Mutunga M, Fulton B, Bullock R (2001) Circulating endothelial cells in patients with septic shock. Am J Respir Crit Care Med 163:195–200
Paulus P, Jennewein C, Zacharowski K (2011) Biomarkers of endothelial dysfunction: can they help us deciphering systemic inflammation and sepsis? Biomarkers 16(51):511–521
Henrich M, Gruss M, Weigand MA (2010) Sepsis-induced degradation of endothelial glycolcalix. Sci World J 18(10):917–923
De Backer D, Donatello K, Taccone FS, Ospina-Tascon G, Salgano D, Vincent JL (2011) Microcirculatory alterations: potential mechanism and implications for therapy. Ann Intensive Care 19(1):27
Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R, Calandra T, Dhainaut JF, Gerlach H, Harvey M, Marini JJ, Marshall J, Ranieri M, Ramsay G, Sevransky J, Thompson BT, Townsend S, Vender JS, Zimmerman JL, Vincent JL (2008) Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med 34:17–60
Perner A, Haase N, Guttormsen AB, Tenhunen J, Klemenzson G, Aneman A, Madsen KR, Moller MH, Helkjaer JM, Poulsen LM, Bendtsen A, Winding R, Steensen M, Berezowicz P, Soe-Jensen P, Bestle M, Strand K, Wiis J, White JO, Thornberg KJ, Quist L, Nielsen J, Andersen LH, Holst LB, Thormar K, Kjaeldgaard AL, Fabritius ML, Mondrup F, Pott FC, Moller TP, Winkel P, Wetterslev J (2012) Hydroxyethyl starch 130/0.42 versus ringer’s acetate in severe sepsis. N Engl J Med 367(2):124–134
Ruiz C, Hernandez G, Ince C (2010) Diagnosis and treatment of the septic microcirculation. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Springer, Berlin, pp 16–26
Boyd JH (2010) Targeted treatment of microvascular dysfunction. In: Vincent JL (ed) Yearbook of intensive care and emergency medicine. Springer, Berlin, pp 16–26
Trzeciak S, Cinel I, Dellinger RP, Shapiro RI, Arnold RC, Parrillo JE, Hollenberg SM (2008) Resuscitating the microcirculation in sepsis: the central role of nitric oxide, emerging concepts for novel therapies, and challenges for clinical trials. Acad Emerg Med 15(5):399–413
Aird WC (2004) Endothelium as an organ system. Crit Care Med 32(5):271–279
Juffermans NP, Vervloet MG, Daemen-Gubbels C, Binnekade MdJ, Groeneveld ABJ (2010) A dose-finding study of methylene blue to inhibit nitric oxide actions in the haemodynamic of human septic shock. Nitric Oxide 15(4):275–280
Heyland DK (2007) Selenium supplementation in critically ill patients: can too much of a good thing be a bad thing? Crit Care 11:153
Reinhart K, Brunkhorst FM, Bone H-G, Bardutzky J, Dempfle C-E, Forst H, et al (2010) Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2 k guidelines of the German sepsis society (Deutsche Sepsis-Gesellschaft e.V. (DSG)) and the German Interdisciplinary association of intensive care and emergency medicine (Deutsche Interdisziplinäre Vereinigung für Intensiv- und Notfallmedizin (DIVI)). Ger Med Sci 8: Doc14
Forceville X, Laviolle B, Annane D, Vitoux D, Bleichner G, Korach J-M, Cantais E, Georges, H, Soubirou J-L, Combes A, Bellissant E (2007) Effects of high doses of selenium, as sodium selenite, in septic shock: a placebo-controlled, randomized, double-blind, phase II study. Crit. Care 11:R73
London NR, Zhu W, Bozza FA, et al (2010) Targeting Robo4-dependentslit signalling to survive the cytokine storm in sepsis and influenza. Sci Transl Med 2:23ra19
Lee WL, Slutsky AS (2010) Sepsis and endothelial permeability. N Engl J Med 363(7):689–691
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2014 Springer-Verlag Italia
About this chapter
Cite this chapter
Biagioni, E., Girardis, M. (2014). Loss of Self-Regulation in Interstitial Fluid Dynamics of Septic Patients, and Oedema Development Patterns. In: Allaria, B. (eds) Practical Issues in Anesthesia and Intensive Care 2013. Springer, Milano. https://doi.org/10.1007/978-88-470-5529-2_9
Download citation
DOI: https://doi.org/10.1007/978-88-470-5529-2_9
Published:
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-5528-5
Online ISBN: 978-88-470-5529-2
eBook Packages: MedicineMedicine (R0)