• Ferenc Kiss, Levente Molnar, Endre Hajdu, Adam Deak, Abel Molnar, Marianna Berhes, Judit Szabo, Norbert Nemeth, and Bela Fulesdi.
• Institute of Surgery, Faculty of Medicine, University of Debrecen, Hungary.
• Acta Cir Bras. 2015 Jul 1;30(7):470-7.

PurposeIn the pathophysiology of sepsis tissue perfusion dysfunction is a crucial driving force. Thus the early recognition is highly important. Concerning the early hours of bacteremia, and the systemic inflammatory response reaction leading to sepsis we aimed to investigate the micro- and macrocirculatory changes.MethodsIn 20 juvenile Hungahib pigs were anesthetized and the femoral artery and external jugular vein were prepared unilaterally and cannulated. For assisted ventilation tracheostomy was performed. In Sepsis group (n=11) live E. coli was intravenously administered (increasing concentration, 9.5x10∧6 in 3h). In Control group (n=9) bacteria-free saline was administered at the same volume. Modified shock index (MSI), core and skin temperature, and skin microcirculation (laser Doppler) were measured before inducing bacteremia then hourly for 4h.ResultsIn Control group parameters were stable, while six animals in the Sepsis group died before the 4th hour. Core and skin temperature did not show significant alterations. In Sepsis group microcirculation showed a large impairment already by the 1st hour, while in MSI only by the 3rd hour.ConclusionDuring bacteremia and the early phase of sepsis microcirculatory impairment can be detected soon, even hours before the deterioration in hemodynamic parameters in this porcine model.

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