This article is part of the supplement: Re-establishing organ function in severe sepsis: targeting the microcirculation

Review

Microvascular dysfunction as a cause of organ dysfunction in severe sepsis

Jean-Louis Vincent^* and Daniel De Backer

• * Corresponding author: Jean-Louis Vincent jlvincen@ulb.ac.be

Author Affiliations

Department of Intensive Care, Erasme Hospital, Free University of Brussels, Belgium

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Critical Care 2005, 9(Suppl 4):S9-S12 doi:10.1186/cc3748

Published: 25 August 2005

Abstract

Reduced microvascular perfusion has been implicated in organ dysfunction and multiple organ failure associated with severe sepsis. The precise mechanisms underlying microvascular dysfunction remain unclear, but there are considerable experimental data showing reduced microcirculatory flow, particularly of small vessels, and increased heterogeneity. With the development of newer imaging techniques, human studies have also been conducted and have given rise to similar findings. Importantly, the degree of microvascular disturbance and its persistence is associated with poorer outcomes. The ability to influence these changes may result in better outcomes and bedside systems, enabling direct visualization of the microcirculation, which will help in the assessment of ongoing microcirculatory dysfunction and its response to established and new therapeutic interventions.