• Mo-lei Yan, Jing Yan, Jin Chen, Yi-hua Yu, and Guo-long Cai.
• Intensive Care Unit, Zhejiang Chinese Medical University, Hangzhou 310013, China.
• Zhonghua Yi Xue Za Zhi. 2013 Jul 2;93(25):1965-9.

ObjectiveTo explore the changes of sublingual microcirculation in elderly patients with severe sepsis/septic shock.MethodsTwenty-three patients with sepsis, 10 patients without sepsis and 10 healthy elderly patients were enrolled. Sublingual microcirculation was evaluated by sidestream darkfield (SDF) imaging. And the 28-day mortality rates of all septic patients were recorded.ResultsCompared with the healthy group, all elderly patients had significant sublingual microcirculation dysfunctions. Compared with the severe septic and nonseptic patients, perfused vessel density (PDV) , proportion of perfused vessels (PPV) and microvascular flow index (MFI) of septic shocks were significantly lower. Compared with the severe septic patients, PDV, PPV and MFI instead of lactate and MAP of septic shocks were significantly lower from Day 1 to Day 3. The values of PDV, PPV, MFI and lactate but not MAP of the surviving septic patients were significantly higher than those of the deceased ones.ConclusionsThe elderly patients with septic shock have severe sublingual microcirculatory alterations. And these abnormalities are more marked in septic shock patients. Nonsurvivors showed more severe alterations than survivors. Microcirculatory alterations may be measured to guide the therapy.

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