Estudo da cinética da disfunção microcirculatória de órgãos na sepse em ratos

• Ano de defesa: 2016
• Autor(a) principal: Vieira, José Custódio Feres [UNIFESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• dARK ID: ark:/48912/001300001j0d7
• Idioma: por
• Instituição de defesa: Universidade Federal de São Paulo (UNIFESP)
• Palavras-chave em Português: Sepsis; Microcirculation; Sidestream dark field imaging; Microcirculatory heterogeneity; Sepse; Microcirculação; Heterogeneidade microcirculatória
• Link de acesso: https://sucupira.capes.gov.br/sucupira/public/consultas/coleta/trabalhoConclusao/viewTrabalhoConclusao.jsf?popup=true&id_trabalho=3686584; http://repositorio.unifesp.br/handle/11600/47776

The microcirculatory dysfunction has been identified as the main factor in the genesis of Multiple Organ Dysfunction Syndrome in sepsis, and macrocirculatory measurements does not present a direct and progressive relationship with the evolution of organ failure, while the microcirculation dysfunction represents an early sign of systemic worsening. Objective: evaluate and compare the dynamics of microcirculatory dysfunction of different compartments in sepsis. Methods: Female Wistar-EPM, young adult, 200-250g, were subjected to sepsis (2mL E. coli 109 CFU / mL, intravenous), with mortality rate of approximately 80% in 26 hours, and the kinetic evolution of microcirculatory dysfunction in liver, kidney, jejunum and sublingual compartments were captured by SidestreamDarkField Imaging (SDF) videomicroscopy and the images were evaluated by the qualitative (visual), quantitative and additional parameters with program (AVA 3 .2) methods, in the first 6 hours of sepsis (T0-T6 hours).Results: The results showed that the microcirculation is organ-specific, in terms of the vascular architecture, the type and composition of microvessels and microcirculatory dynamics, making them more or less susceptible to sepsis progression according to their characteristics. Conclusion: The overall results showed that the dynamic microcirculatory is organ-specific. Despite the differences observed by the quantitative analysis performed by the AVA system, the temporal evolution of microcirculatory dysfunction in sepsis was similar in liver, kidney and sublingual. The quantitative analysis of the microcirculation distinguished between the healthy and septic state but was not able to detect differences among the periods of severe microcirculatory dysfunction. Through the analysis of images per period (qualitative analysis) was not possible to differentiate the evolution of sepsis in sublingual and jejunum, unlike observed in the solid organs.