From bench to bedside.

Because the microcirculation has emerged as an important reanimation target, appropriate methods to monitor the microcirculatory function are crucial. Several teams have now succeeded in crossing this bridge from bench to bedside, but the choice of the tissues of interest remains a debate. The potential accessible vascular beds that doctors could use in reanimation strategies and the relationship of these beds to more relevant microcirculatory ones are important issues to address.

Evaluation of sublingual and gut mucosal microcirculation in sepsis: a quantitative analysis.

Objective: To determine the relationship between sublingual and intestinal mucosal microcirculatory perfusion.

Design: Observational, experimental study.

Setting: University-affiliated large animal laboratory.

Prediction of postoperative complications after urgent laparotomy by intraperitoneal microdialysis: A pilot study.

Objective: The aim of the present study was to investigate the role of intraperitoneal microdialysis (IPM) techniques in monitoring the evolution of postoperative critically ill patients requiring urgent laparotomy.

Summary Background Data: Postoperative intraabdominal sepsis is associated with an important degree of morbidity and mortality in acutely ill patients. Early diagnosis is critical to improve outcomes.

The following is the abstract of the article discussed in the subsequent letter:

Sublingual and intestinal mucosal blood flow and Pco(2) were studied in a canine model of endotoxin-induced circulatory shock and resuscitation. Sublingual Pco(2) (Ps(CO(2))) was measured by using a novel fluorescent optrode-based technique and compared with lingual measurements obtained by using a Stowe-Severinghaus electrode [lingual Pco(2) (Pl(CO(2)))]. Endotoxin caused parallel changes in cardiac output, and in portal, intestinal mucosal, and sublingual blood flow (Q(s)).

15th Annual Congress of the European Society of Intensive Care Medicine, 29 September-2 October 2002, Barcelona, Spain: clinical research to improve outcome.

The 15Annual European Society of Intensive Care Medicine Meeting opened in Barcelona, Spain on September 30, 2002. This report focuses on some highlights of this congress. Preliminary data from the Sepsis Occurrence in the Acutely ill Patient (SOAP) study are presented, as are findings from the Assessment of Low Tidal Volume and Elevated End-Expiratory Volume to Obviate Lung Injury (ALVEOLI) study, which compared higher positive end-expiratory pressure (PEEP)/lower fractional inspired oxygen (FiO) with lower PEEP/higher FiOstrategies.