Microcirculação na sepse: aspectos fisiopatológicos e diagnósticos

• DOI: 10.12957/rhupe.2013.7527
• Publication Date: 2013-09-30T19:11:30Z
• Authors: Marcos L. Miranda; Daniella M. L. Ca...; Eliete Bouskela
• Keywords: Organ dysfunction; Pathophysiology

Due to its high incidence, morbidity, mortality and cost the healthcare system, sepsis stands out among many indications for intensive care unit admission. The microcirculatory dysfunction plays a central role in genesis maintenance of septic syndrome, being pathophysiologic milestone this syndrome. In fact, one can say that is disorder microcirculation first organ fail during progression multiple syndrome death. It now known that, despite adequate treatment macro-hemodynamics, there little correlation between improvement systemic hemodynamics correction abnormalities, presence these abnormalities more common non survivors than survivors. reason disparity macro micro‑hemodynamics functional shunts “hide” from circulation. By not assessing intrinsic events occur microcirculation, conventional hemodynamic monitoring systems available clinical practice detect such response treatments. This knowledge points great need diagnosis sepsis: diagnostic evaluation dysfunction. Fortunately, are some methods specifically targeted alterations. These be divided into biomarkers, videomicroscopy techniques, techniques assessment tissue oxygenation using partial pressure carbon dioxide. Aiming at better understanding pathophysiological processes involved sepsis’s dysfunction, currently tools, fundamental concepts presented.