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...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Zühre Uz, C. Ince, L. Shen, B. Ergin, T. M. van Gulik
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/2c5b5374fc9b48d1947ef42ad1ec900a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:2c5b5374fc9b48d1947ef42ad1ec900a
record_format	dspace
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
_version_	1718393199647522816

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

Ejemplares similares