title: Relationship between sublingual and intestinal microcirculatory perfusion in patients with abdominal sepsis.
abstract: OBJECTIVE
  To evaluate the relation between sublingual and intestinal microcirculatory alterations in patients with abdominal sepsis.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  A 23-bed mixed intensive care unit of a tertiary teaching hospital.
  
  
  METHODS
  Twenty-three patients with abdominal sepsis and a newly constructed intestinal stoma were included in the study group. Nineteen outpatient healthy individuals with an intestinal stoma and ten nonsepsis patients with a <24-hr-old intestinal stoma were included as controls.
  
  
  METHODS
  None.
  
  
  RESULTS
  Orthogonal polarization spectral imaging of the sublingual and intestinal microcirculation was performed on days 1 and 3. In addition, variables of systemic hemodynamics, such as cardiac index, heart rate, blood pressure, central venous pressure, and dosages of vasopressor and inotropic agents, were obtained. On day 1 there was no correlation of the microvascular flow index between the sublingual and intestinal microcirculatory beds (Spearman's rho [rs] = .12; 95% confidence interval, -.51 to .31; p = .59). Furthermore, there was no significant correlation between microcirculatory alterations and variables of systemic circulation (rs <or= .25). On day 3, however, a correlation between sublingual and intestinal microcirculatory flow appeared to be restored (rs = .74; 95% confidence interval, .28-.92; p = .006), mainly due to a normalization of flow in both regions.
  
  
  CONCLUSIONS
  On day 1 of abdominal sepsis there is a complete dispersion of flow, not only between hemodynamic compartments of a different order but also between the sublingual and intestinal microcirculation. Over time, both sublingual and intestinal microvascular flow indexes trended to normal values.
authors.affiliation: Department of Physiology, Academic Medical Center, University of Amsterdam, The Netherlands.
authors.forename: E Christiaan
authors.initials: EC
authors.lastname: Boerma
authors.forename: Peter H J
authors.initials: PH
authors.lastname: van der Voort
authors.forename: Peter E
authors.initials: PE
authors.lastname: Spronk
authors.forename: Can
authors.initials: C
authors.lastname: Ince
mesh_terms: D000005:Abdomen; D000368:Aged; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units; D007422:Intestines / Q000098:blood supply* / Q000601:surgery; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D009060:Mouth Floor / Q000098:blood supply*; D011446:Prospective Studies; D018805:Sepsis / Q000401:mortality / Q000503:physiopathology*; D012720:Severity of Illness Index; D054047:Surgical Stomas