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The microcirculation as a diagnostic and therapeutic target in sepsis

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Abstract

The microcirculation is defined as the smallest vessels where gas and nutrient exchange with tissues takes place. One of its primary functions is to ensure adequate oxygen delivery to meet the oxygen demands of tissue cells. Previous data from clinical and experimental studies and the recent development of new imaging modalities, such as Orthogonal Polarization Spectral videomicroscopy and Sidestream Dark Field imaging, have helped to identify the crucial role that microcirculation plays in sepsis. If not corrected, microcirculatory dysfunction can lead to respiratory distress in tissue cells and subsequent organ failure, even in the absence of global hemodynamic deficiency. In the present review, we will address past and recent developments regarding the role of the microcirculation as an important target in the pathogenesis of sepsis and its progression to multiple organ failure. Accordingly, we identify the microcirculation as an important diagnostic and therapeutic target for treatment in sepsis.

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Acknowledgments

Dr. Shapiro is supported by grants from the National Heart Lung and Blood Institute (RO1HLO91757) and the National Institute of General Medical Sciences 1P50GM076659-01 (Shapiro). Dr. Trzeciak is supported by a grant from the National Institutes of Health/National Institutes of General Medical Sciences (K23GM83211).

Conflict of interest statement

The authors declare that they have no conflict of interest related to the publication of this manuscript.

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Authors and Affiliations

  1. Department of Surgical and Medical Critical Care, University of Florence, Florence, Italy

    Andrea Nencioni

  2. Division of Critical Care Medicine, Department of Emergency Medicine, Cooper University Hospital, Robert Wood Johnson Medical School at Camden, University of Medicine and Dentistry of New Jersey (UMDNJ), Camden, NJ, USA

    Stephen Trzeciak

  3. Department of Emergency Medicine, Beth Israel Deaconess Medical Center, 1 Deaconess Road, CC2-W, Boston, MA, 02215, USA

    Nathan I. Shapiro

Authors
  1. Andrea Nencioni
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  2. Stephen Trzeciak
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  3. Nathan I. Shapiro
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Correspondence to Nathan I. Shapiro.

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Nencioni, A., Trzeciak, S. & Shapiro, N.I. The microcirculation as a diagnostic and therapeutic target in sepsis. Intern Emerg Med 4, 413–418 (2009). https://doi.org/10.1007/s11739-009-0297-5

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  • DOI: https://doi.org/10.1007/s11739-009-0297-5

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