title: Early course of microcirculatory perfusion in eye and digestive tract during hypodynamic sepsis.
abstract: BACKGROUND
  The aim of the study was to evaluate and compare the microcirculatory perfusion during experimental sepsis in different potentially available parts of the body, such as sublingual mucosa, conjunctiva of the eye, and mucosa of jejunum and rectum.
  
  
  METHODS
  Pigs were randomly assigned to sepsis (n = 9) and sham (n = 4) groups. The sepsis group received a fixed dose of live Escherichia coli infusion over a 1-hour period (1.8 × 10(9)/kg colony-forming units). Animals were observed 5 hours after the start of E. coli infusion. In addition to systemic hemodynamic assessment, we performed conjunctival, sublingual, jejunal, and rectal evaluation of microcirculation by using Sidestream Dark Field (SDF) videomicroscopy at the same time points: at baseline, and at 3 and 5 hours after the start of live E. coli infusion. Assessment of microcirculatory parameters of convective oxygen transport (microvascular flow index (MFI) and proportion of perfused vessels (PPV)), and diffusion distance (perfused vessel density (PVD) and total vessel density (TVD)) was done by using a semiquantitative method.
  
  
  RESULTS
  Infusion of E. coli resulted in a hypodynamic state of sepsis associated with low cardiac output and increased systemic vascular resistance despite fluid administration. Significant decreases in MFI and PPV of small vessels were observed in sublingual, conjunctival, jejunal, and rectal locations 3 and 5 hours after the start of E. coli infusion in comparison with baseline variables. Correlation between sublingual and conjunctival (r = 0.80; P = 0.036), sublingual and jejunal (r = 0.80; P = 0.044), and sublingual and rectal (r = 0.79; P = 0.03) MFI was observed 3 hours after onset of sepsis. However, this strong correlation between the sublingual and other regions disappeared 5 hours after the start of E. coli infusion. Overall, the sublingual mucosa exhibited the most-pronounced alterations of microcirculatory flow in comparison with conjunctival, jejunal, and rectal microvasculature (P < 0.05).
  
  
  CONCLUSIONS
  In this pig model, a time-dependent correlation exists between sublingual and microvascular beds during the course of a hypodynamic state of sepsis.
authors.forename: Andrius
authors.initials: A
authors.lastname: Pranskunas
authors.forename: Vidas
authors.initials: V
authors.lastname: Pilvinis
authors.forename: Zilvinas
authors.initials: Z
authors.lastname: Dambrauskas
authors.forename: Renata
authors.initials: R
authors.lastname: Rasimaviciute
authors.forename: Rita
authors.initials: R
authors.lastname: Planciuniene
authors.forename: Paulius
authors.initials: P
authors.lastname: Dobozinskas
authors.forename: Vincentas
authors.initials: V
authors.lastname: Veikutis
authors.forename: Dinas
authors.initials: D
authors.lastname: Vaitkaitis
authors.forename: E Christiaan
authors.initials: EC
authors.lastname: Boerma
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D005123:Eye / Q000098:blood supply*; D041981:Gastrointestinal Tract / Q000098:blood supply*; D008833:Microcirculation / Q000502:physiology; D018715:Microscopy, Video / Q000379:methods; D011897:Random Allocation; D018805:Sepsis / Q000473:pathology / Q000503:physiopathology*; D013552:Swine; D013997:Time Factors