Colbert James F, Schmidt Eric P
Division of Infectious Diseases, Department of Medicine, University of Colorado School of Medicine, 12700 E. 19th Avenue, Aurora, CO 80045, USA.
Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, Denver Health Medical Center, University of Colorado School of Medicine, 12700 E. 19th Avenue, Aurora, CO 80045, USA.
Clin Chest Med. 2016 Jun;37(2):263-75. doi: 10.1016/j.ccm.2016.01.009. Epub 2016 Mar 4.
The microcirculation is a series of arterioles, capillaries, and venules that performs essential functions of oxygen and nutrient delivery, customized to the unique physiologic needs of the supplied organ. The homeostatic microcirculatory response to infection can become harmful if overactive and/or dysregulated. Pathologic microcirculatory dysfunction can be directly visualized by intravital microscopy or indirectly measured via detection of circulating biomarkers. Although several treatments have been shown to protect the microcirculation during sepsis, they have not improved patient outcomes when applied indiscriminately. Future outcomes-oriented studies are needed to test sepsis therapeutics when personalized to a patient's microcirculatory dysfunction.
微循环是由一系列小动脉、毛细血管和小静脉组成，它执行着输送氧气和营养物质的基本功能，并根据所供应器官的独特生理需求进行定制。如果对感染的稳态微循环反应过度活跃和/或失调，可能会变得有害。病理性微循环功能障碍可通过活体显微镜直接观察，或通过检测循环生物标志物间接测量。尽管已经证明几种治疗方法可在脓毒症期间保护微循环，但不加区分地应用时并未改善患者预后。未来需要开展以结果为导向的研究，以测试针对患者微循环功能障碍进行个性化治疗的脓毒症疗法。
