Real-time observation of microcirculatory leukocytes in patients undergoing major liver resection

Abstract Ischemia/reperfusion injury and inflammation are associated with microcirculatory dysfunction, endothelial injury and glycocalyx degradation. This study aimed to assess microcirculation in the sublingual, intestinal and the (remnant) liver in patients undergoing major liver resection, to de...

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Autores principales: Zühre Uz, C. Ince, L. Shen, B. Ergin, T. M. van Gulik
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Lenguaje:EN
Publicado: Nature Portfolio 2021
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Acceso en línea:https://doaj.org/article/2c5b5374fc9b48d1947ef42ad1ec900a
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spelling oai:doaj.org-article:2c5b5374fc9b48d1947ef42ad1ec900a2021-12-02T13:20:21ZReal-time observation of microcirculatory leukocytes in patients undergoing major liver resection10.1038/s41598-021-83677-02045-2322https://doaj.org/article/2c5b5374fc9b48d1947ef42ad1ec900a2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-83677-0https://doaj.org/toc/2045-2322Abstract Ischemia/reperfusion injury and inflammation are associated with microcirculatory dysfunction, endothelial injury and glycocalyx degradation. This study aimed to assess microcirculation in the sublingual, intestinal and the (remnant) liver in patients undergoing major liver resection, to define microcirculatory leukocyte activation and its association with glycocalyx degradation. In this prospective observational study, the microcirculation was assessed at the beginning of surgery (T0), end of surgery (T1) and 24 h after surgery (T2) using Incident Dark Field imaging. Changes in vessel density, blood flow and leukocyte behaviour were monitored, as well as clinical parameters. Syndecan-1 levels as a parameter of glycocalyx degradation were analysed. 19 patients were included. Sublingual microcirculation showed a significant increase in the number of rolling leukocytes between T0 and T1 (1.5 [0.7–1.8] vs. 3.7 [1.7–5.4] Ls/C-PCV/4 s respectively, p = 0.001), and remained high at T2 when compared to T0 (3.8 [3–8.5] Ls/C-PCV/4 s, p = 0.006). The microvascular flow decreased at T2 (2.4 ± 0.3 vs. baseline 2.8 ± 0.2, respectively, p < 0.01). Duration of vascular inflow occlusion was associated with significantly higher numbers of sublingual microcirculatory rolling leukocytes. Syndecan-1 increased from T0 to T1 (42 [25–56] vs. 107 [86–164] ng/mL, p < 0.001). The microcirculatory perfusion was characterized by low convection capacity and high number of rolling leukocytes. The ability to sublingually monitor the rolling behaviour of the microcirculatory leukocytes allows for early identification of patients at risk of increased inflammatory response following major liver resection.Zühre UzC. InceL. ShenB. ErginT. M. van GulikNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-15 (2021)
institution DOAJ
collection DOAJ
language EN
topic Medicine
R
Science
Q
spellingShingle Medicine
R
Science
Q
Zühre Uz
C. Ince
L. Shen
B. Ergin
T. M. van Gulik
Real-time observation of microcirculatory leukocytes in patients undergoing major liver resection
description Abstract Ischemia/reperfusion injury and inflammation are associated with microcirculatory dysfunction, endothelial injury and glycocalyx degradation. This study aimed to assess microcirculation in the sublingual, intestinal and the (remnant) liver in patients undergoing major liver resection, to define microcirculatory leukocyte activation and its association with glycocalyx degradation. In this prospective observational study, the microcirculation was assessed at the beginning of surgery (T0), end of surgery (T1) and 24 h after surgery (T2) using Incident Dark Field imaging. Changes in vessel density, blood flow and leukocyte behaviour were monitored, as well as clinical parameters. Syndecan-1 levels as a parameter of glycocalyx degradation were analysed. 19 patients were included. Sublingual microcirculation showed a significant increase in the number of rolling leukocytes between T0 and T1 (1.5 [0.7–1.8] vs. 3.7 [1.7–5.4] Ls/C-PCV/4 s respectively, p = 0.001), and remained high at T2 when compared to T0 (3.8 [3–8.5] Ls/C-PCV/4 s, p = 0.006). The microvascular flow decreased at T2 (2.4 ± 0.3 vs. baseline 2.8 ± 0.2, respectively, p < 0.01). Duration of vascular inflow occlusion was associated with significantly higher numbers of sublingual microcirculatory rolling leukocytes. Syndecan-1 increased from T0 to T1 (42 [25–56] vs. 107 [86–164] ng/mL, p < 0.001). The microcirculatory perfusion was characterized by low convection capacity and high number of rolling leukocytes. The ability to sublingually monitor the rolling behaviour of the microcirculatory leukocytes allows for early identification of patients at risk of increased inflammatory response following major liver resection.
format article
author Zühre Uz
C. Ince
L. Shen
B. Ergin
T. M. van Gulik
author_facet Zühre Uz
C. Ince
L. Shen
B. Ergin
T. M. van Gulik
author_sort Zühre Uz
title Real-time observation of microcirculatory leukocytes in patients undergoing major liver resection
title_short Real-time observation of microcirculatory leukocytes in patients undergoing major liver resection
title_full Real-time observation of microcirculatory leukocytes in patients undergoing major liver resection
title_fullStr Real-time observation of microcirculatory leukocytes in patients undergoing major liver resection
title_full_unstemmed Real-time observation of microcirculatory leukocytes in patients undergoing major liver resection
title_sort real-time observation of microcirculatory leukocytes in patients undergoing major liver resection
publisher Nature Portfolio
publishDate 2021
url https://doaj.org/article/2c5b5374fc9b48d1947ef42ad1ec900a
work_keys_str_mv AT zuhreuz realtimeobservationofmicrocirculatoryleukocytesinpatientsundergoingmajorliverresection
AT cince realtimeobservationofmicrocirculatoryleukocytesinpatientsundergoingmajorliverresection
AT lshen realtimeobservationofmicrocirculatoryleukocytesinpatientsundergoingmajorliverresection
AT bergin realtimeobservationofmicrocirculatoryleukocytesinpatientsundergoingmajorliverresection
AT tmvangulik realtimeobservationofmicrocirculatoryleukocytesinpatientsundergoingmajorliverresection
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