Skip to main content
  • 332 Accesses

Abstract

The microcirculation (MC) is the terminal region of the circulatory system that is fundamental in the pathophysiology of sepsis and septic shock. As is well known, its main components are arterioles, venules, shunts, and mostly capillaries. All the structures in the MC are capable of contraction, except capillaries which are made of endothelial cells alone, without contractile structures, except those (named “precapillary sphincters”) placed at the beginning of the vessels.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Maglietta M (1989) Objectives for the treatment of the microcirculation in ischaemia, shock and reperfusion. In: Update in intensive care and emergency medicine. Springer-Verlag, Berlin Heidelberg New York

    Google Scholar 

  2. Zweifach BW, Thomas L (1957) The relationship between the vascular manifestations of shock produced by endotoxin, trauma and haemorrhage. J Exp Med 106: 385–401

    Article  PubMed  CAS  Google Scholar 

  3. Menger MD, Steiner D, Messmer K (1992) Microvascular ischaemia reperfusion in striated muscle. Significance of ‘no reflow’. Am J Physiol 263: H1892 - H1900

    PubMed  CAS  Google Scholar 

  4. Lam C, Tymil K, Martin C et al (1994) Microvascular perfusion is impaired in a rat model of normotensive sepsis. J Clin Invest 94: 2077–2083

    Article  PubMed  CAS  Google Scholar 

  5. Astiz ME, De Gent GE, Lyn RY et al (1995) Microvascular function and rheologic changes in hyperdynamic sepsis. Crit Care Med 23: 265–271

    Article  PubMed  CAS  Google Scholar 

  6. Novelli GP, De Gaudio AR, Melani AM (1995) Oxygen uptake and delivery. In: 24th Congress of Anesthesiology, Vienna 4–8 Sept 1995. Springer, Berlin Heidelberg New York, pp 337–341

    Google Scholar 

  7. Fiddian-Green RG, Baker S (1987) Predictive value of the stomach wall pH for complications after cardiac operations. Comparison with other monitoring. Crit Care Med 15: 153–156

    Article  PubMed  CAS  Google Scholar 

  8. Grum CM, Fiddian-Green RG, Pittenger GL et al (1984) Adequacy of tissue oxygenation in intact dog intestine. J Appi Physiol 56: 1065–1069

    CAS  Google Scholar 

  9. Gutierrez G, Palisaz F, Doglio G et al (1992) Gastric intramucosal pH as a therapeutic index of tissue oxygenation in critically ill patients. Lancet 339: 195–199

    Article  PubMed  CAS  Google Scholar 

  10. Tang W, Weil MH, Sun S et al (1994) Gastric intramucosal pC02 as monitor of perfusion failure during haemorrhagic and anaphylactic shock. J Appi Physiol 76: 752–757

    Google Scholar 

  11. Kolkman JJ, Otte JA, Groeneveld ABJ (2000) Gastrointestinal luminal pC02 tonometry: an update on physiology, methodology and clinical applications. Br J Anaesth 84: 74–86

    Article  PubMed  CAS  Google Scholar 

  12. Brinkmann A, Calzia E, Trager K et al (1998) Monitoring the hepato-splancnic region in the critically ill patient. Intensive Care Med 24: 542–556

    Article  PubMed  CAS  Google Scholar 

  13. Tenhunen JJ, Kosunen H, Alava E et al (1999) Intestinal luminal microdialysis. A new approach to assess gut mucosal ischaemic. Anesthesiology 91: 1807–1815

    Article  PubMed  CAS  Google Scholar 

  14. Waxman K (1998) Shock: ischaemia, reperfusion and inflammation. New Horiz 4: 158–159

    Google Scholar 

  15. Francdgiannis, Youker KA, Rossen RD et al (1998) Cytokines and the microcirculation in ischaemia and reperfusion. J Mol Cell Cardiol 30: 2567–2576

    Article  Google Scholar 

  16. Greenberg S, Curro SA, Tanaka PT (1983) Regulation of vascular smooth muscle of the microcirculation. In: Mortillaro N (ed) The physiology and pharmacology of microcirculation. Academic Press, New York, pp 39–141

    Chapter  Google Scholar 

  17. Parratt JR (1989) Alterations in vascular reactivity in sepsis and endotoxemia. In: Vincent JL (ed) Update in intensive care and emergency medicine. Springer, Berlin Heidelberg New York, pp 27–40

    Google Scholar 

  18. Evequoz D, Waeber B, Corder R et al (1987) Markedly reduced blood pressure responsiveness in endotoxemic rats: reversal by neuropeptide Y. Life Sci 41: 2573–2580

    Article  PubMed  CAS  Google Scholar 

  19. Christmas JW, Lancaster LH, Blackwell TS (1988) Nuclear factor kB: a pilotai role in the systemic inflammatory response syndrome and new target for therapy. Intensive Care Med 24: 1131–1138

    Article  Google Scholar 

  20. Essani NA, Fisher MA, Jaeschke H (1997) Inhibition of NF-kB activation by dimethylsulfoxide correlates with the suppression of TNF-alpha formation, reduced ICAM gene transcription and protection against endotoxin-induced liver injury. Shock 7: 90–96

    Article  PubMed  CAS  Google Scholar 

  21. Armstead VE, Operntanova IL, Miinchenko AG et al (1999) Tissue factor expression in vital organs during traumatic shock. Anesthesiology 91: 1844–1852

    Article  PubMed  CAS  Google Scholar 

  22. Kirkeboen KA, Strand OA (1999) The role of nitric oxide in sepsis: an overview. Acta Anaesthiol Scand 43: 275–278

    Article  CAS  Google Scholar 

  23. Spain DA, Wilson MA, Bar-Natan MF et al (1994) Role of nitric oxide in the small intestinal microcirculation during bacteremia. Shock 2: 41–46

    Article  PubMed  CAS  Google Scholar 

  24. Novelli GP, Livi P, Adembri C, Melani AM (1995) Which is the role of NO in sepsis and shock. In: Brandi MD (ed) I Orvieto Simp. On development of nitric oxide, Orvieto, pp 35–38

    Google Scholar 

  25. Novelli GP, Livi P, Melani AM et al (1994) Il nitrossido nell’insufficienza circolatoria. Minerva Anestiol 60[Suppl] 1: 201–208

    Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2001 Springer-Verlag Italia

About this paper

Cite this paper

Novelli, G.P. (2001). New Insight Into the Role of Microcirculation in Shock. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2903-3_3

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2903-3_3

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-0136-7

  • Online ISBN: 978-88-470-2903-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics