title: Laser speckle contrast imaging for measurement of hepatic microcirculation during the sepsis: a novel tool for early detection of microcirculation dysfunction.
abstract: BACKGROUND
  Sepsis is a fatal systemic inflammatory response syndrome caused by severe infection. The aim of this study was to measure hepatic microcirculation during the sepsis with laser speckle contrast imaging (LSCI), as well as investigating the underlying mechanisms.
  
  
  METHODS
  Sepsis was induced by cecal ligation and puncture. Rats were divided into the sham group and sepsis group. The hepatic microcirculation was monitored with LSCI. In addition, hepatic endothelial function (expression of cell adhesion molecules, coagulation and vascular permeability) and neutrophils accumulation in the liver were compared between the two groups.
  
  
  RESULTS
  During the sepsis, hepatic microcirculation decreased dramatically (290.3±70.1 LSPU (laser speckle perfusion units) at baseline vs. 230.4±60.7 LSPU at 12h vs. 125.2±25.4 LSPU at 48h, P<0.001). The rats developed hyperbilirubinemia since 6h. In the early phase of sepsis, the accumulation of neutrophils and formation of microthrombus increased rapidly. In the late phase, hepatic neutrophils accumulation was already at its maximum level. Meanwhile, the endothelial coagulation status shifted from procoagulation to anticoagulation. The vascular leakage was involved in the microcirculation dysfunction since 12h after sepsis.
  
  
  CONCLUSIONS
  Hepatic microcirculation dysfunction occurs early during the sepsis and is associated with liver injury. This microcirculation dysfunction is due to neutrophil-endothelium interactions, microthrombus formation and vascular leakage.
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, PR China.
authors.forename: Yin
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, PR China. Electronic address: JiananR@gmail.com.
authors.forename: Jianan
authors.initials: J
authors.lastname: Ren
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, PR China.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, PR China.
authors.forename: Chao
authors.initials: C
authors.lastname: Ding
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, PR China.
authors.forename: Jun
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, PR China.
authors.forename: Gefei
authors.initials: G
authors.lastname: Wang
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, PR China.
authors.forename: Guosheng
authors.initials: G
authors.lastname: Gu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, PR China.
authors.forename: Song
authors.initials: S
authors.lastname: Liu
authors.affiliation: Department of Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, PR China.
authors.forename: Jieshou
authors.initials: J
authors.lastname: Li
mesh_terms: D000818:Animals; D001777:Blood Coagulation; D001783:Blood Flow Velocity; D002199:Capillary Permeability; D015815:Cell Adhesion Molecules / Q000378:metabolism; D004195:Disease Models, Animal; D042241:Early Diagnosis; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology; D008099:Liver / Q000098:blood supply*; D008102:Liver Circulation; D008297:Male; D008833:Microcirculation; D055806:Microvessels / Q000378:metabolism / Q000503:physiopathology*; D020556:Neutrophil Infiltration; D011237:Predictive Value of Tests; D017207:Rats, Sprague-Dawley; D012039:Regional Blood Flow; D012212:Rheology / Q000379:methods*; D018805:Sepsis / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology; D013997:Time Factors
chemical_list: D015815:Cell Adhesion Molecules
keywords: Coagulation; Laser speckle contrast imaging; Leakage; Liver; Microcirculation; Microthrombus; Neutrophil; Sepsis; Vascular; endothelium