title: Assessments of skin and tongue microcirculation reveals major changes in porcine sepsis.
abstract: OBJECTIVE
  To examine the relation between central hemodynamics, clinical severity and microvascular findings in tongue and skin during sepsis.
  
  
  METHODS
  Skin and tongue microcirculation was examined using laser Doppler and video microscopy techniques before and 200 min after inducing sepsis in pigs (n=6) by inactivated Neisseria meningitides and in two control animals.
  
  
  RESULTS
  All infected pigs developed clinical signs of sepsis. Pericapillary bleedings developed in the tongue in the two pigs with the most severe disease. Capillary density increased in the groin skin in infected pigs after 200 min as compared to baseline (P<0·02). In the same period, mean capillary flow velocity was reduced in groin skin and tongue in septic pigs (P<0·02). At 200 min a fraction of capillaries had developed 'no flow' or 'brisk flow', patterns hardly seen at baseline. Laser Doppler perfusion was reduced in ear and tongue after 200 min (P<0·02 for both). The described pathology was more pronounced in the pigs with the most severe sepsis.
  
  
  CONCLUSIONS
  Capillary bleedings may be used as an early indication of severe sepsis. Examination of skin and tongue microcirculations may be used to characterize severity of sepsis and possibly to assess effect of treatment.
authors.affiliation: Department of Cardio-thoracic surgery, Oslo Unversity Hospital and University of Oslo, Oslo, Norway. torjus.wester@medisin.uio.no
authors.forename: Torjus
authors.initials: T
authors.lastname: Wester
authors.forename: E
authors.initials: E
authors.lastname: Häggblad
authors.forename: Z A
authors.initials: ZA
authors.lastname: Awan
authors.forename: A
authors.initials: A
authors.lastname: Barratt-Due
authors.forename: M
authors.initials: M
authors.lastname: Kvernebo
authors.forename: P S
authors.initials: PS
authors.lastname: Halvorsen
authors.forename: T E
authors.initials: TE
authors.lastname: Mollnes
authors.forename: K
authors.initials: K
authors.lastname: Kvernebo
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity; D002196:Capillaries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004195:Disease Models, Animal; D005260:Female; D017078:Laser-Doppler Flowmetry; D008297:Male; D008833:Microcirculation; D018715:Microscopy, Video; D009345:Neisseria meningitidis / Q000472:pathogenicity; D012039:Regional Blood Flow; D018805:Sepsis / Q000000981:diagnostic imaging / Q000382:microbiology / Q000503:physiopathology*; D012720:Severity of Illness Index; D012867:Skin / Q000098:blood supply*; D013552:Swine; D013997:Time Factors; D014059:Tongue / Q000098:blood supply*; D014463:Ultrasonography