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Markers of the microcirculation were not.
Also the beneficial effects of citrulline supplementation during LPS infusion on the microcirculation were not present in eNOS-/ or double KO mice, although citrulline significantly enhanced the plasma arginine availability in all mouse strains.
Regrettably, despite both groups were managed using the same clinical protocols, as far as other interventions that might affect the microcirculation were not computed (such as red blood cell transfusion), we cannot attribute this improvement to DrotAA therapy.
However, because of the uncontrolled design of our study, we cannot rule out that changes observed on hemodynamics and microcirculation were not related to HVHF.
Moreover, changes in the cerebral microcirculation were not related to changes in MAP, CI or lactate, suggesting that these alterations in the brain may occur even when global perfusion pressure is maintained, such as in non-hypotensive conditions.
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Whether RRI reflects the systemic circulation or renal microcirculation is not well known.
However, as the relationship between systemic hemodynamics and microcirculation are not straightforward [25, 26], the assessment of microcirculation might also improve our understanding of the effects of passive mobilization beyond changes to systemic hemodynamics.
The mechanisms by which fluids may improve the microcirculation are not well understood but may be related to a decrease in viscosity, to a decrease in white blood cell adhesion and rolling, or, indirectly, to a decrease in endogenous vasoconstrictive substances.
Its effects on oxygen delivery and microcirculation are not well known.
The impact of sepsis on the brain microcirculation is not well defined.
Patients whose microcirculation is not responsive to such resuscitation, however, have a poor prognosis [ 2].
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