Fuchs Alexander, Neumann Tobias, Drinhaus Hendrik, Herrmann Anika, Vink Hans, Annecke Thorsten
Faculty of Medicine and University Hospital of Cologne, Department of Anaesthesiology and Intensive Care Medicine, University of Cologne, Cologne, Germany.
Department of Physiology, Maastricht University Medical Center, Maastricht, The Netherlands.
J Clin Monit Comput. 2022 Apr;36(2):371-377. doi: 10.1007/s10877-021-00660-w. Epub 2021 Feb 3.
The endothelium and the glycocalyx play a pivotal role in regulating microvascular function and perfusion in health and critical illness. It is unknown today, whether aerobic exercise immediately affects dimensions of the endothelial surface layer (ESL) in relation to microvascular perfusion as a physiologic adaption to increased nutritional demands. This monocentric observational study was designed to determine real-time ESL and perfusion measurements of the sublingual microcirculation using sidestream dark field imaging performed in 14 healthy subjects before and after completing a 10 km trial running distance. A novel image acquisition and analysis software automatically analysed the perfused boundary region (PBR), an inverse parameter for red blood cell (RBC) penetration of the ESL, in vessels between 5 and 25 µm diameter. Microvascular perfusion was assessed by calculating RBC filling percentage. There was no significant immediate effect of exercise on PBR and RBC filling percentage. Linear regression analysis revealed a distinct association between change of PBR and change of RBC filling percentage (regression coefficient β: - 0.026; 95% confidence interval - 0.043 to - 0.009; p = 0.006). A single aerobic exercise did not induce a change of PBR or RBC filling percentage. The endothelium of the microvasculature facilitates efficient perfusion in vessels reacting with an increased endothelial surface layer.
内皮细胞和糖萼在健康和危重病状态下调节微血管功能和灌注方面起着关键作用。目前尚不清楚,有氧运动作为对营养需求增加的一种生理适应,是否会立即影响与微血管灌注相关的内皮表面层(ESL)的尺寸。这项单中心观察性研究旨在通过对14名健康受试者在完成10公里跑步试验前后进行侧流暗视野成像,来确定舌下微循环的实时ESL和灌注测量值。一种新型图像采集和分析软件自动分析了直径在5至25微米之间血管中的灌注边界区域(PBR),这是红细胞(RBC)穿透ESL的一个反向参数。通过计算RBC充盈百分比来评估微血管灌注。运动对PBR和RBC充盈百分比没有显著的即时影响。线性回归分析显示PBR变化与RBC充盈百分比变化之间存在显著关联(回归系数β:-0.026;95%置信区间-0.043至-0.009;p = 0.006)。单次有氧运动并未引起PBR或RBC充盈百分比的变化。微血管的内皮细胞有助于在血管中进行有效灌注,并与增加的内皮表面层发生反应。