Skin microcirculatory changes reflect early the circulatory deterioration in a fulminant sepsis model in the pig.
OBJECTIVE
In the pathophysiology of sepsis tissue perfusion dysfunction is a crucial driving force. Thus the early recognition is highly important. Concerning the early hours of bacteremia, and the systemic inflammatory response reaction leading to sepsis we aimed to investigate the micro- and macrocirculatory changes.


METHODS
In 20 juvenile Hungahib pigs were anesthetized and the femoral artery and external jugular vein were prepared unilaterally and cannulated. For assisted ventilation tracheostomy was performed. In Sepsis group (n=11) live E. coli was intravenously administered (increasing concentration, 9.5x10∧6 in 3h). In Control group (n=9) bacteria-free saline was administered at the same volume. Modified shock index (MSI), core and skin temperature, and skin microcirculation (laser Doppler) were measured before inducing bacteremia then hourly for 4h.


RESULTS
In Control group parameters were stable, while six animals in the Sepsis group died before the 4th hour. Core and skin temperature did not show significant alterations. In Sepsis group microcirculation showed a large impairment already by the 1st hour, while in MSI only by the 3rd hour.


CONCLUSIONS
During bacteremia and the early phase of sepsis microcirculatory impairment can be detected soon, even hours before the deterioration in hemodynamic parameters in this porcine model.
Institute of Surgery, Faculty of Medicine, University of Debrecen, Hungary.
Ferenc
F
Kiss
Department of Anesthesiology and Intensive, Faculty of Medicine, University of Debrecen, Hungary.
Levente
L
Molnar
Department of Anesthesiology and Intensive, Faculty of Medicine, University of Debrecen, Hungary.
Endre
E
Hajdu
Faculty of Medicine, University of Debrecen, Hungary.
Adam
A
Deak
Institute of Surgery, Faculty of Medicine, University of Debrecen, Hungary.
Abel
A
Molnar
Faculty of Medicine, University of Debrecen, Hungary.
Marianna
M
Berhes
Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, University of Debrecen, Hungary.
Judit
J
Szabo
Institute of Medical Microbiology, Faculty of Medicine, University of Debrecen, Hungary.
Norbert
N
Nemeth
Institute of Surgery, Faculty of Medicine, University of Debrecen, Hungary.
Bela
B
Fulesdi
D000818:Animals; D016470:Bacteremia / Q000503:physiopathology*; D004195:Disease Models, Animal; D004927:Escherichia coli Infections / Q000503:physiopathology; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D017078:Laser-Doppler Flowmetry; D008833:Microcirculation / Q000502:physiology*; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D012772:Shock, Septic / Q000503:physiopathology; D012867:Skin / Q000098:blood supply*; D012881:Skin Temperature / Q000502:physiology*; D013552:Swine; D013997:Time Factors