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Trzeciak et al. [14] also observed that early (within 3 h) improvement of sublingual microcirculation in response to resuscitation procedures was associated with an improvement of organ function at 24 h, whereas patients whose microcirculation did not improve experienced a worsening of organ function.
Moreover, in a recent study in cardiac surgery patients, an impaired microcirculation did not affect accuracy of two interstitial glucose sensors from two different manufacturers [ 28].
As the changes in microcirculation did not correlate to changes in macrocirculation, however, the authors suggested that the macro- and microcirculation do not have the same dose-response to fluid loading.
Interestingly, in the study by Krejci and colleagues the microcirculation did not invariably parallel the macro-circulatory flow: whereas liver microcirculatory perfusion remained unchanged despite reduced total liver blood flow, capillary blood flow in the pancreas and kidney was impaired.
Trzeciak et al. [ 14] also observed that early (within 3 h) improvement of sublingual microcirculation in response to resuscitation procedures was associated with an improvement of organ function at 24 h, whereas patients whose microcirculation did not improve experienced a worsening of organ function.
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Disturbances of regional microcirculation do not correlate with the global indices of perfusion such as the cardiac index and cardiac output.
However, the higher reperfusion-induced ROS may not be completely explained by more effective microcirculatory restoration, because HTS was comparably effective in restoring splanchnic microcirculation but did not induce higher renal ROS formation than the synthetic colloids.
The transfusion of leukodepleted RBCs was able to improve microvascular perfusion and tissue oxygenation in patients with a relatively healthy microcirculation [ 40, 41] but did not show any significant effect in severely septic patients with dysfunctional microcirculation [ 20].
In the patients with NIRS measurements (10 in the HF protocol and 7 in the MF protocol), the effects of NMES on the microcirculation of the exercising muscle did not differ between the two protocols.
In studied patients with type 1 diabetes, the skin microcirculation after l-arginine infusion did not differ between patients with and without microangiopathy.
In addition, hirudin, a pure thrombin inhibitor, did not improve the microcirculation of septic animals [45].
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