open access

Vol 48, No 4 (2016)
Review articles
Published online: 2016-09-21
Submitted: 2016-07-26
Accepted: 2016-09-18
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Sepsis and septic shock-is a microcirculation a main player?

Małgorzata Lipinska-Gediga
DOI: 10.5603/AIT.a2016.0037
·
Anaesthesiol Intensive Ther 2016;48(4):261-265.

open access

Vol 48, No 4 (2016)
Review articles
Published online: 2016-09-21
Submitted: 2016-07-26
Accepted: 2016-09-18

Abstract

Shock, defined at a cellular level, is a condition in which oxygen delivery to the cells is not sufficient to sustain cellular activity and support organ function. The central role of microcirculation in providing oxygen to the cells makes it of prime importance in determining organ function. In sepsis and septic shock, macrocirculatory alterations and microcirculatory dysfunction participate concurrently in the pathophysiology of organ failure. Haemodynamic coherence in shock is a condition in which normalization of systemic haemodynamic variables results in simultaneous amelioration in the perfusion of the microcirculation and restoration of tissue oxygenation as a final result. Septic shock is most frequently characterized by a lack of microcirculatory recruitment despite of macrocirculatory successful resuscitation. The lack of haemodynamic coherence between macrocirculation and microcirculation in septic patients results in treatment failure and increased mortality. The monitoring of microcirculation and the effects of its changes are an important area of future clinical research and treatment modification.

Abstract

Shock, defined at a cellular level, is a condition in which oxygen delivery to the cells is not sufficient to sustain cellular activity and support organ function. The central role of microcirculation in providing oxygen to the cells makes it of prime importance in determining organ function. In sepsis and septic shock, macrocirculatory alterations and microcirculatory dysfunction participate concurrently in the pathophysiology of organ failure. Haemodynamic coherence in shock is a condition in which normalization of systemic haemodynamic variables results in simultaneous amelioration in the perfusion of the microcirculation and restoration of tissue oxygenation as a final result. Septic shock is most frequently characterized by a lack of microcirculatory recruitment despite of macrocirculatory successful resuscitation. The lack of haemodynamic coherence between macrocirculation and microcirculation in septic patients results in treatment failure and increased mortality. The monitoring of microcirculation and the effects of its changes are an important area of future clinical research and treatment modification.

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Keywords

sepsis; microcirculation; tissue perfusion; endothelium

About this article
Title

Sepsis and septic shock-is a microcirculation a main player?

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 48, No 4 (2016)

Pages

261-265

Published online

2016-09-21

DOI

10.5603/AIT.a2016.0037

Bibliographic record

Anaesthesiol Intensive Ther 2016;48(4):261-265.

Keywords

sepsis
microcirculation
tissue perfusion
endothelium

Authors

Małgorzata Lipinska-Gediga

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