The Microcirculation as a Therapeutic Target in the Treatment of Sepsis and Shock

Vanina S. Kanoore Edul, M.D.; Arnaldo Dubin, M.D., Ph.D.; Can Ince, Ph.D.

Disclosures

Semin Respir Crit Care Med. 2011;32(5):558-568. 

In This Article

The Microcirculation in Health and Disease

The key physiological function of the microcirculation is to provide oxygen transport to the tissues to sustain cellular and thereby organ function. The microcirculation is composed of a network of arterioles, capillaries, and venules that connect the arterial and venous systems. The morphology of this network has a highly heterogeneous structure that differs from organ to organ depending on the regional metabolic demand and function. Besides the important function of the regulation and distribution of oxygen within the different organ systems, the microcirculation plays a key role in the immune system and delivers a variety of nutrients and hormones to the parenchymal cells. In addition the microcirculation has a variety of other specialized functions in certain organs, such as thermoregulation. The homeostasis of these highly regulated processes becomes severely altered during critical illness. Especially during sepsis, microcirculatory dysfunction can be considered to initiate the sequence of events that leads to multiple organ failure (MOF).[5] During the last few years, the identification and correction of those abnormalities have been the focus of many experimental and clinical studies.[6]

This article reviews the characteristics of microcirculatory dysfunction that occur during experimental and clinical sepsis and the potential therapeutic options to correct these alterations.

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