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Microcirculatory dysfunction and tissue oxygenation in critical illness

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Microcirculatory dysfunction and tissue oxygenation in critical illness. / Østergaard, Leif; Granfeldt, A; Secher, N; Tietze, A; Iversen, N K; Jensen, Morten Skovgaard; Andersen, Kristian Kjær; Nagenthiraja, K; Gutiérrez-Lizardi, P; Mouridsen, K; Jespersen, S N; Tønnesen, E K.

In: Acta Anaesthesiologica Scandinavica, Vol. 59, No. 10, 01.11.2015, p. 1246-59.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Harvard

Østergaard, L, Granfeldt, A, Secher, N, Tietze, A, Iversen, NK, Jensen, MS, Andersen, KK, Nagenthiraja, K, Gutiérrez-Lizardi, P, Mouridsen, K, Jespersen, SN & Tønnesen, EK 2015, 'Microcirculatory dysfunction and tissue oxygenation in critical illness', Acta Anaesthesiologica Scandinavica, vol. 59, no. 10, pp. 1246-59. https://doi.org/10.1111/aas.12581

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Author

Østergaard, Leif ; Granfeldt, A ; Secher, N ; Tietze, A ; Iversen, N K ; Jensen, Morten Skovgaard ; Andersen, Kristian Kjær ; Nagenthiraja, K ; Gutiérrez-Lizardi, P ; Mouridsen, K ; Jespersen, S N ; Tønnesen, E K. / Microcirculatory dysfunction and tissue oxygenation in critical illness. In: Acta Anaesthesiologica Scandinavica. 2015 ; Vol. 59, No. 10. pp. 1246-59.

Bibtex

@article{ad0fc193d5ef45b5b487be634ff36a0a,
title = "Microcirculatory dysfunction and tissue oxygenation in critical illness",
abstract = "Severe sepsis is defined by organ failure, often of the kidneys, heart, and brain. It has been proposed that inadequate delivery of oxygen, or insufficient extraction of oxygen in tissue, may explain organ failure. Despite adequate maintenance of systemic oxygen delivery in septic patients, their morbidity and mortality remain high. The assumption that tissue oxygenation can be preserved by maintaining its blood supply follows from physiological models that only apply to tissue with uniformly perfused capillaries. In sepsis, the microcirculation is profoundly disturbed, and the blood supply of individual organs may therefore no longer reflect their access to oxygen. We review how capillary flow patterns affect oxygen extraction efficacy in tissue, and how the regulation of tissue blood flow must be adjusted to meet the metabolic needs of the tissue as capillary flows become disturbed as observed in critical illness. Using the brain, heart, and kidney as examples, we discuss whether disturbed capillary flow patterns might explain the apparent mismatch between organ blood flow and organ function in sepsis. Finally, we discuss diagnostic means of detecting capillary flow disturbance in animal models and in critically ill patients, and address therapeutic strategies that might improve tissue oxygenation by modifying capillary flow patterns.",
author = "Leif {\O}stergaard and A Granfeldt and N Secher and A Tietze and Iversen, {N K} and Jensen, {Morten Skovgaard} and Andersen, {Kristian Kj{\ae}r} and K Nagenthiraja and P Guti{\'e}rrez-Lizardi and K Mouridsen and Jespersen, {S N} and T{\o}nnesen, {E K}",
note = "{\textcopyright} 2015 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.",
year = "2015",
month = nov,
day = "1",
doi = "10.1111/aas.12581",
language = "English",
volume = "59",
pages = "1246--59",
journal = "Acta Anaesthesiologica Scandinavica",
issn = "0001-5172",
publisher = "Wiley-Blackwell Publishing, Inc.",
number = "10",

}

RIS

TY - JOUR

T1 - Microcirculatory dysfunction and tissue oxygenation in critical illness

AU - Østergaard, Leif

AU - Granfeldt, A

AU - Secher, N

AU - Tietze, A

AU - Iversen, N K

AU - Jensen, Morten Skovgaard

AU - Andersen, Kristian Kjær

AU - Nagenthiraja, K

AU - Gutiérrez-Lizardi, P

AU - Mouridsen, K

AU - Jespersen, S N

AU - Tønnesen, E K

N1 - © 2015 The Authors. Acta Anaesthesiologica Scandinavica published by John Wiley & Sons Ltd on behalf of Acta Anaesthesiologica Scandinavica Foundation.

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Severe sepsis is defined by organ failure, often of the kidneys, heart, and brain. It has been proposed that inadequate delivery of oxygen, or insufficient extraction of oxygen in tissue, may explain organ failure. Despite adequate maintenance of systemic oxygen delivery in septic patients, their morbidity and mortality remain high. The assumption that tissue oxygenation can be preserved by maintaining its blood supply follows from physiological models that only apply to tissue with uniformly perfused capillaries. In sepsis, the microcirculation is profoundly disturbed, and the blood supply of individual organs may therefore no longer reflect their access to oxygen. We review how capillary flow patterns affect oxygen extraction efficacy in tissue, and how the regulation of tissue blood flow must be adjusted to meet the metabolic needs of the tissue as capillary flows become disturbed as observed in critical illness. Using the brain, heart, and kidney as examples, we discuss whether disturbed capillary flow patterns might explain the apparent mismatch between organ blood flow and organ function in sepsis. Finally, we discuss diagnostic means of detecting capillary flow disturbance in animal models and in critically ill patients, and address therapeutic strategies that might improve tissue oxygenation by modifying capillary flow patterns.

AB - Severe sepsis is defined by organ failure, often of the kidneys, heart, and brain. It has been proposed that inadequate delivery of oxygen, or insufficient extraction of oxygen in tissue, may explain organ failure. Despite adequate maintenance of systemic oxygen delivery in septic patients, their morbidity and mortality remain high. The assumption that tissue oxygenation can be preserved by maintaining its blood supply follows from physiological models that only apply to tissue with uniformly perfused capillaries. In sepsis, the microcirculation is profoundly disturbed, and the blood supply of individual organs may therefore no longer reflect their access to oxygen. We review how capillary flow patterns affect oxygen extraction efficacy in tissue, and how the regulation of tissue blood flow must be adjusted to meet the metabolic needs of the tissue as capillary flows become disturbed as observed in critical illness. Using the brain, heart, and kidney as examples, we discuss whether disturbed capillary flow patterns might explain the apparent mismatch between organ blood flow and organ function in sepsis. Finally, we discuss diagnostic means of detecting capillary flow disturbance in animal models and in critically ill patients, and address therapeutic strategies that might improve tissue oxygenation by modifying capillary flow patterns.

U2 - 10.1111/aas.12581

DO - 10.1111/aas.12581

M3 - Journal article

C2 - 26149711

VL - 59

SP - 1246

EP - 1259

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

SN - 0001-5172

IS - 10

ER -