Abstract

Sepsis is associated with circulatory dysfunction contributing to disturbed blood flow and organ injury. Decreased organ perfusion in sepsis is attributed, in part, to the loss of vasoregulatory mechanisms. Identifying which vascular beds are most susceptible to dysfunction is important for monitoring the recovery of organ function and guiding interventions. This study aimed to investigate the development of vascular dysfunction as sepsis progressed to septic shock. Anesthetized C57Bl/6 mice were instrumented with a fiberoptic pressure sensor in the carotid artery for blood pressure measurements. In subgroups of mice, regional blood flow measurements were taken by positioning a perivascular flow probe around either the left carotid, left renal, or superior mesenteric arteries. Hemodynamic parameters and their responsiveness to bolus doses of vasoactive drugs were recorded prior to and continuously after injection of fecal slurry (1.3 mg/g body weight) for 4 h. Fecal slurry-induced peritonitis reduced mean arterial pressure (62.7 ± 2.4 mmHg vs. 37.5 ± 3.2 mmHg in vehicle and septic mice, respectively), impaired cardiac function, and eventually reduced organ blood flow (71.9%, 66.8%, and 65.1% in the superior mesenteric, renal, and carotid arteries, respectively). The mesenteric vasculature exhibited dysregulation before the renal and carotid arteries, and this underlying dysfunction preceded the blood pressure decline and impaired organ blood flow.

Highlights

  • IntroductionSepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection

  • Introduction published maps and institutional affilSepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection

  • Using a murine model of fecal slurry (FS)-induced peritonitis (FIP), we showed that the development of vascular dysfunction and regional blood flow perturbation in sepsis is not uniform; instead, certain vascular beds exhibit dysregulation before the others, and this underlying dysfunction precedes the blood pressure (BP) decline and impaired blood flow to these organs

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Summary

Introduction

Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. It is characterized by perturbations in immune, humoral, and circulatory function, which result in increased mortality, and needs urgent care, compared with ‘straightforward infections’ [1]. Clinical management of patients with sepsis relies on early recognition of the syndrome, allowing for the rapid institution of antibiotics, source control, and resuscitation with fluids. Vasoactive drugs constitute a mainstay of treatment for life-threatening hypotension [1]. While treating hypotension is important for survival, the administration of vasopressors, in excess, can compound blood flow disruptions to organs in sepsis, and the resultant organ hypoperfusion may offset the survival benefits of normotension

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