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Online ISSN 1827-1596
SMART 2003 - Milan, may 28-30, 2003
De Backer D.
Department of Intensive Care, Erasme University Hospital, Free University of Brussels, Belgium
Microcirculatory alterations have been widely described in experimental models of sepsis, however the microcirculation have long been neglected in septic patients as traditional techniques do not allow the visualisation of the microcirculation. The Orthogonal Polarization Spectral (OPS) imaging technique allows the direct visualisation of the microcirculation at the bedside. A selected review of the articles on the microcirculation in patients with sepsis using the OPS imaging technique, is made. Patients severe sepsis present a decrease in capillary density and a decrease in the proportion of the perfused capillaries. The severity of these alterations is more pronounced in non survivors than in survivors, and is related with the development of multiple organ failure. These alterations can be reversed by vasodilators, either topically applied or administered intravenously. Microvascular blood flow alterations are frequently observed in patients with sepsis and can have major pathophysiological implications.