The Heterogeneity of the Microcirculation in Critical Illness
The Heterogeneity of the Microcirculation in Critical Illness
复制标题
DOI：
10.1016/j.ccm.2008.06.008
复制
发表时间：
2008-12-01
影响因子：
5.7
通讯作者：
Ince, Can
中科院分区：
文献类型：
--
作者：
Klijn, Eva;Den Uil, C. A.;Ince, Can
微循环是器官结构的一个复杂而特殊的方面，它的特征根据它所供应的组织的功能而变化。可以直接观察患者微循环的床边技术，如正交偏振光谱成像和侧流暗场成像，为研究这一网络及其组成部分开辟了道路，特别是在危重疾病和外科手术中。这些研究强调了微循环在围手术期疾病状态中的核心作用。他们还强调了器官系统之间和特定器官内微循环性质的变化。在实验研究的支持下，目前的研究更好地定义了危重疾病中微循环改变的本质以及这些改变对治疗的反应。本文综述了迄今为止在危重病人的微循环床上进行的研究。讨论了微循环网络的功能解剖和这些网络在危重疾病发病机制中的作用。还描述了在手术和床边重症监护期间观察到的微血管床的形态，包括大脑、舌下区域、皮肤、肠道和眼睛的微血管床。
Microcirculation, a complex and specialized facet of organ architecture, has characteristics that vary according to the function of the tissue it supplies. Bedside technology that can directly observe microcirculation in patients, such as orthogonal polarization spectral imaging and sidestream dark field imaging, has opened the way to investigating this network and its components, especially in critical illness and surgery. These investigations have underscored the central role of microcirculation in perioperative disease states. They have also highlighted variations in the nature of microcirculation, both among organ systems and within specific organs. Supported by experimental studies, current investigations are better defining the nature of microcirculatory alterations in critical illness and how these alterations respond to therapy. This review focuses on studies conducted to date on the microcirculatory beds of critically ill patients. The functional anatomy of microcirculation networks and the role of these networks in the pathogenesis of critical illness are discussed. The morphology of microvascular beds that have been visualized during surgery and intensive care at the bedside are also described, including those of the brain, sublingual region, skin, intestine, and eyes.