title: Effects of volume resuscitation on the microcirculation in animal models of lipopolysaccharide sepsis: a systematic review.
abstract: BACKGROUND
  Recent research has identified an increased rate of mortality associated with fluid bolus therapy for severe sepsis and septic shock, but the mechanisms are still not well understood. Fluid resuscitation therapy administered for sepsis and septic shock targets restoration of the macro-circulation, but the pathogenesis of sepsis is complex and includes microcirculatory dysfunction.
  
  
  OBJECTIVE
  The objective of the study is to systematically review data comparing the effects of different types of fluid resuscitation on the microcirculation in clinically relevant animal models of lipopolysaccharide-induced sepsis.
  
  
  METHODS
  A structured search of PubMed/MEDLINE and EMBASE for relevant publications from 1 January 1990 to 31 December 2015 was performed, in accordance with PRISMA guidelines.
  
  
  RESULTS
  The number of published papers on sepsis and the microcirculation has increased steadily over the last 25 years. We identified 11 experimental animal studies comparing the effects of different fluid resuscitation regimens on the microcirculation. Heterogeneity precluded any meta-analysis.
  
  
  CONCLUSIONS
  Few animal model studies have been published comparing the microcirculatory effects of different types of fluid resuscitation for sepsis and septic shock. Biologically relevant animal model studies remain necessary to enhance understanding regarding the mechanisms by which fluid resuscitation affects the microcirculation and to facilitate the transfer of basic science discoveries to clinical applications.
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.|Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Nchafatso G
authors.initials: NG
authors.lastname: Obonyo
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Jonathon P
authors.initials: JP
authors.lastname: Fanning
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Angela S Y
authors.initials: AS
authors.lastname: Ng
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.
authors.forename: Leticia P
authors.initials: LP
authors.lastname: Pimenta
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Kiran
authors.initials: K
authors.lastname: Shekar
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia.
authors.forename: David G
authors.initials: DG
authors.lastname: Platts
authors.affiliation: Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.|Department of Paediatrics, Faculty of Medicine, Imperial College London, London, UK.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Maitland
authors.affiliation: Critical Care Research Group, The Prince Charles Hospital, Brisbane, Queensland, Australia. fraserjohn001@gmail.com.|School of Medicine, University of Queensland, Brisbane, Queensland, Australia. fraserjohn001@gmail.com.
authors.forename: John F
authors.initials: JF
authors.lastname: Fraser
keywords: Fluid resuscitation; Intravital fluorescence microscopy; Laser Doppler flowmetry; Laser speckle imaging; Lipopolysaccharide; Microcirculation; Oxygen extraction; Sepsis; Septic shock; Sidestream dark-field videomicroscopy