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Doubtlessly, severe liver microcirculatory abnormalities can be found in the presence of normal total hepatic flow.
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Patients with septic shock characteristically exhibit different kinds of sublingual microcirculatory abnormalities.
The report concluded that the microcirculatory abnormalities were consistent with a non-specific organic microangiopathy.
Interestingly, the majority of our patients exhibited significant microcirculatory abnormalities, irrespective of the status of lactate clearance.
Severe microcirculatory abnormalities can be detected in hyperdynamic septic shock patients, but their role on lactate clearance is unclear.
Interestingly, these microcirculatory abnormalities are not explained by routinely measured global macro-hemodynamic variables, making it attractive to assess them directly [11, 12].
Taken together, our current and previous data suggest that persistent microcirculatory abnormalities after 24 h of resuscitation may represent different pathogenic mechanisms not responsive to DO2 increasing maneuvers.
Recent data have highlighted the prognostic importance of microcirculatory abnormalities in patients with shock using noninvasive bedside techniques, such as sublingual video-microscopy [5 8].
Furthermore, microcirculatory abnormalities and its persistence despite adequate macro-hemodynamic resuscitation were independently associated with morbidity and mortality in many critical conditions [6 12].
De Backer and colleagues reported similar microcirculatory abnormalities in septic patients [ 7].
This feature, together with class III microcirculatory abnormalities, also identifies this condition as distributive shock.
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