• 1. Guyton AC, Coleman TG, Granger HJ. Circulation: overall regulation. Annu Rev Physiol 1972;34:1346.

  • 2. De Backer D, Orbegozo Cortes D, Donadello K, et al. Pathophysiology of microcirculatory dysfunction and the pathogenesis of septic shock. Virulence 2014;5:7379.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3. Bezemer R, Bartels SA, Bakker J, et al. Clinical review: clinical imaging of the sublingual microcirculation in the critically ill—where do we stand? Crit Care 2012;16:224.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4. Tafner PFDA, Chen FK, Filho RR, et al. Recent advances in bedside microcirculation assessment in critically ill patients. Rev Bras Ter Intensiva 2017;29:238247.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5. Hurcombe SD, Welch BR, Williams JM, et al. Dark-field microscopy in the assessment of large colon microperfusion and mucosal injury in naturally occurring surgical disease of the equine large colon. Equine Vet J 2014;46:674680.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 6. Hopster K, Neudeck S, Wittenberg-Voges L, et al. The relationship between intestinal and oral mucosa microcirculation in anaesthetized horses. Vet Anaesth Analg 2018;45:7881.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7. De Backer D, Creteur J, Preiser JC, et al. Microvascular blood flow is altered in patients with sepsis. Am J Respir Crit Care Med 2002;166:98104.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8. Edul VSK, Ince C, Navarro N, et al. Dissociation between sublingual and gut microcirculation in the response to a fluid challenge in postoperative patients with abdominal sepsis. Ann Intensive Care 2014;4:39.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9. De Backer D, Hollenberg S, Boerma C, et al. How to evaluate the microcirculation: report of a round table conference. Crit Care 2007;11:R101.

  • 10. Ince C. The microcirculation is the motor of sepsis. Crit Care 2005;9(Suppl 4):S13S19.

  • 11. Goedhart J, Vermeer JEM, Adjobo-Hermans MJW, et al. Sensitive detection of p65 homodimers using red-shifted and fluorescent protein-based FRET couples. PLoS One 2007;2:e1011.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12. De Backer D, Ospina-Tascon G, Salgado D, et al. Monitoring the microcirculation in the critically ill patient: current methods and future approaches. Intensive Care Med 2010;36:18131825.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13. Gommeren K, Allerton FJ, Morin E, et al. Evaluation of a rapid bedside scoring system for microcirculation videos acquired from dogs: rapid approach for evaluation of microcirculation in dogs. J Vet Emerg Crit Care 2014;24:554561.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14. Mullen KM, Regier PJ, Londoño LA, et al. Evaluation of jejunal microvasculature of healthy anesthetized dogs with sidestream dark field video microscopy. Am J Vet Res 2020;81:888893.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15. Verdant CL, De Backer D, Bruhn A, et al. Evaluation of sublingual and gut mucosal microcirculation in sepsis: a quantitative analysis. Crit Care Med 2009;37:28752881.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16. Kieffer PJ, Williams JM, Shepard MK, et al. Comparison of the oral and rectal mucosal and colonic serosal microcirculations of healthy, anesthetized horses. Can J Vet Res 2018;82:5559.

    • Search Google Scholar
    • Export Citation
  • 17. De Backer D, Ortiz JA, Salgado D. Coupling microcirculation to systemic hemodynamics. Curr Opin Crit Care 2010;16:250254.

  • 18. Magnin M, Foulon É, Lurier T, et al. Evaluation of microcirculation by sidestream dark field imaging: impact of hemodynamic status on the occurrence of pressure artifacts—a pilot study. Microvasc Res 2020;131:104025.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19. Trzeciak S, McCoy JV, Phillip Dellinger R, et al. Early increases in microcirculatory perfusion during protocol-directed resuscitation are associated with reduced multi-organ failure at 24 h in patients with sepsis. Intensive Care Med 2008;34:22102217.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20. Peruski AM, Cooper ES. Assessment of microcirculatory changes by use of sidestream dark field microscopy during hemorrhagic shock in dogs. Am J Vet Res 2011;72:438445.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21. Goodnight ME, Cooper ES, Butler AL. Assessment of microcirculatory perfusion in healthy anesthetized cats undergoing ovariohysterectomy using sidestream dark field microscopy: microcirculatory perfusion assessment in cats undergoing ovariohysterectomy. J Vet Emerg Crit Care (San Antonio) 2015;25:349357.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22. Silverstein DC, Cozzi EM, Hopkins AS, et al. Microcirculatory effects of intravenous fluid administration in anesthetized dogs undergoing elective ovariohysterectomy. Am J Vet Res 2014;75:809817.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23. Hesselkilde EZ, Almind ME, Petersen J, et al. Cardiac arrhythmias and electrolyte disturbances in colic horses. Acta Vet Scand 2014;56:58.

  • 24. McDonell WN. General anesthesia for equine gastrointestinal and obstetric procedures. Vet Clin North Am Large Anim Pract 1981;3:163194.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25. Foth PW, Scott VH, Mudge MC, et al. Prevalence of intra-abdominal hypertension in horses with colic. J Vet Emerg Crit Care (San Antonio) 2020;30:647652.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26. Jacquet-Lagrèze M, Allaouchiche B, Restagno D, et al. Gut and sublingual microvascular effect of esmolol during septic shock in a porcine model. Crit Care 2015;19:241.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27. Hopster K, Hopster-Iversen C, Geburek F, et al. Temporal and concentration effects of isoflurane anaesthesia on intestinal tissue oxygenation and perfusion in horses. Vet J 2015;205:6268.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 28. Cardinali M, Magnin M, Bonnet-Garin JM, et al. A new photoplethysmographic device for continuous assessment of urethral mucosa perfusion: evaluation in a porcine model. J Clin Monit Comput 2021;35:585598.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 29. Thooft A, Favory R, Salgado DR, et al. Effects of changes in arterial pressure on organ perfusion during septic shock. Crit Care 2011;15:R222.

  • 30. Bidwell L. Multimodal pain management of the horse with acute abdomen. In: Robinson NE, Sprayberry KA, eds. Current therapy in equine medicine. 6th ed. St Louis: Saunders Elsevier, 2009;386388.

    • Search Google Scholar
    • Export Citation
  • 31. Boerma EC, van der Voort PHJ, Spronk PE, et al. Relationship between sublingual and intestinal microcirculatory perfusion in patients with abdominal sepsis. Crit Care Med 2007;35:10551060.

    • Crossref
    • Search Google Scholar
    • Export Citation

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Evaluation of the sublingual microcirculation with sidestream dark field video microscopy in horses anesthetized for an elective procedure or intestinal surgery

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  • 1 From the APCSe Unit UPSP 2016.A101, VetAgro Sup, University of Lyon, 69280 Marcy-l'Étoile, France
  • | 2 From the Anesthesia Service at the Veterinary Campus of Lyon, VetAgro Sup, University of Lyon, 69280 Marcy-l'Étoile, France
  • | 3 From the Department of Pharmacology, Faculty of Agronomy and Veterinary Medicine, Lebanese University, Beirut, Lebanon
  • | 4 From the Lyon University Hospital Center, ICU, 69310 Pierre-Bénite, France
  • | 5 From the Department of Anesthesia, Hospital Center Pierre Oudot, 38300 Bourgoin-Jallieu, France

Abstract

OBJECTIVE

To compare the sublingual microcirculation between healthy horses anesthetized for elective procedures and horses with colic anesthetized for abdominal surgery and to determine the effect of mean arterial blood pressure (MAP) on the microcirculation.

ANIMALS

9 horses in the elective group and 8 horses in the colic group.

PROCEDURES

Sublingual microcirculation was assessed with sidestream dark field video microscopy. Videos were captured at 3 time points during anesthesia. Recorded microvasculature parameters were De Backer score (DBS), total density of perfused vessels (PVD) and small vessels (PVD-S), total proportion of perfused vessels (PPV) and small vessels (PPV-S), vascular flow index (MFI), and heterogeneity index (HI). Blood pressure during hypotensive (MAP < 60 mm Hg) and normotensive (MAP ≥ 60 mm Hg) episodes was also recorded.

RESULTS

During normotensive episodes, the elective group had significantly better PPV and PPV-S versus the colic group (median PPV, 76% vs 50%; median PPV-S, 73% vs 51%). In both groups, PPV decreased during anesthesia (elective group, −29%; colic group, −16%) but significantly improved in the elective group 15 minutes before the end of anesthesia (59%). During hypotensive episodes, PVD-S was better preserved in the colic group (11.1 vs 3.8 mm/mm2). No differences were identified for the microcirculatory parameters between normo- and hypotensive episodes in the colic group.

CONCLUSIONS AND CLINICAL RELEVANCE

Sublingual microcirculation was better preserved in healthy horses anesthetized for elective procedures than in horses with colic anesthetized for abdominal surgery despite resuscitation maneuvers. Results indicated that the macrocirculation and microcirculation in critically ill horses may be independent.

Abstract

OBJECTIVE

To compare the sublingual microcirculation between healthy horses anesthetized for elective procedures and horses with colic anesthetized for abdominal surgery and to determine the effect of mean arterial blood pressure (MAP) on the microcirculation.

ANIMALS

9 horses in the elective group and 8 horses in the colic group.

PROCEDURES

Sublingual microcirculation was assessed with sidestream dark field video microscopy. Videos were captured at 3 time points during anesthesia. Recorded microvasculature parameters were De Backer score (DBS), total density of perfused vessels (PVD) and small vessels (PVD-S), total proportion of perfused vessels (PPV) and small vessels (PPV-S), vascular flow index (MFI), and heterogeneity index (HI). Blood pressure during hypotensive (MAP < 60 mm Hg) and normotensive (MAP ≥ 60 mm Hg) episodes was also recorded.

RESULTS

During normotensive episodes, the elective group had significantly better PPV and PPV-S versus the colic group (median PPV, 76% vs 50%; median PPV-S, 73% vs 51%). In both groups, PPV decreased during anesthesia (elective group, −29%; colic group, −16%) but significantly improved in the elective group 15 minutes before the end of anesthesia (59%). During hypotensive episodes, PVD-S was better preserved in the colic group (11.1 vs 3.8 mm/mm2). No differences were identified for the microcirculatory parameters between normo- and hypotensive episodes in the colic group.

CONCLUSIONS AND CLINICAL RELEVANCE

Sublingual microcirculation was better preserved in healthy horses anesthetized for elective procedures than in horses with colic anesthetized for abdominal surgery despite resuscitation maneuvers. Results indicated that the macrocirculation and microcirculation in critically ill horses may be independent.

Contributor Notes

Address correspondence to Dr. Mansour (christelle-mansour@hotmail.com).