La microcirculación en el paciente crítico. Parte I: Generalidades y fsiología en el paciente séptico

Alejandro Donoso F., Daniela Arriagada S., Pablo Cruces R., Franco Díaz R.

Resultado de la investigación: Contribución a una revistaArtículo de revisiónrevisión exhaustiva

1 Cita (Scopus)

Resumen

Severe sepsis and septic shock involve circulatory, inflammatory and metabolic disorders eventually resulting in a disruption of cellular energy. Microcirculatory disturbances are common in septic patients. Microcir-culation is the primary site of oxygen and nutrients exchange to cells. Direct observation using Sidestream Dark Field (SDF) imaging has allowed direct visualization of microcirculatory failure in critically ill patients. Septic shock is characterized by weak or vulnerable microcirculatory units and heterogeneity of microcircula-tory fow. Multiple mechanisms may contribute to these alterations, including endothelial dysfunction, altered glycocalyx, impaired inter-cell communication and adhesion and rolling of white blood cells and platelets. Many therapeutic interventions routinely used in the treatment of critically ill patients seem to result in limited changes in microcirculatory perfusion, irrespective of systemic hemodynamics, due to the heterogeneous nature of these changes and the potentially involved mechanisms. Therefore, microcirculatory alterations and their presence in states of shock, especially in septic shock, can represent diagnostic and severity stratification tools and may be a target for therapeutic intervention (microcirculatory resuscitation), besides suggesting a prognostic role.

Título traducido de la contribuciónMicrocirculation in the critically ill. Part I: Review and physiology of septic patients
Idioma originalEspañol
Páginas (desde-hasta)83-92
Número de páginas10
PublicaciónRevista Chilena de Pediatria
Volumen84
N.º1
DOI
EstadoPublicada - feb 2013

Palabras clave

  • Capillary
  • Circulatory failure
  • Endothelium
  • Microcirculation
  • Organ failure
  • Sepsis
  • Shock

Áreas temáticas de ASJC Scopus

  • Pediatría, perinaltología y salud infantil

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