Objective: The purpose of this study is to investigate the characteristic of microcirculation in healthy volunteers and patients with septic shock in both Xining (2 260 m) and Nanjing (10 m).
Methods: A total of 62 cases, 33 healthy volunteers, 22 cases in Xining, (2 260 m above sea level) and 11 cases in Nanjing (10 m above sea level); and 29 septic shock, 13 cases in Xining and 16 cases in Nanjing were collected. The total vessel density (TVD), perfused vessel density (PVD), proportion of perfused vessel (PPV) and microcirculation flow index (MFI) of both healthy volunteers and septic shock had been investigated by using sidestream dark field (SDF). Analyzed and managed the image data by using AVA3.0 software.
Results: In the healthy volunteers in Xining area (22 cases),the volume of TVD (15.59 ±2.58 mm/mm2), PVD (15.58 ±2.58 mm/mm2) and PPV(96.60% ±4.63%) were significant higher than the volume of TVD (10.0 ±2.10 mm/mm2), PVD (10.81 ±2.38 mm/mm2) and PPV (84.24% ±8.00%) of the volunteers (11 cases) in Nanjing (11 cases). But the MFI (2.17 ±0.31) of the healthy volunteers in the Xining was significant lower (P<0.05) than the MFI (3.21 ±0.34) in the healthy volunteers of Nanjing. In the septic shock group (13 cases) in the Xining, the volume of TVD (5.44 ±1.94 mm/mm2), PVD (4.18 ±1.61 mm/mm2), PPV (42.14%±5.38%) and MFI (1.05 ±0.32) compared with the volume of the healthy volunteers in Xining, the TVD (15.59 ±2.58 mm/mm2), PVD (5.58 ±2.58 mm/mm2), PPV (96.60% ±4.63%) and MFI (2.17 ±0.30) were significant lower (P<0.05). In the healthy volunteers compare with septic shock group in Nanjing area, the TVD(6.80±1.72 vs 10.00±2.10, P<0.05), PVD(5.86±1.58 vs10.81±2.38,P<0.05), PPV(45.42±4.86 vs 84.24±4.86, P<0.05), MFI(1.28±0.28 vs 3.21±0.34 P<0.05), there was significant decreased. In the septic shock group in the Xining compared with the septic shock in Nanjing, there was no significant difference. 10 of 13 patients with septic shock were survived in Xining. 13 of 16 patients with septic shock were survived in Nanjing.
Conclusions: The changes of physiological and pathophysiological characteristic in microcirculation induced by hypoxia would be useful for clinical treatment of septic shock at high altitude.
Keywords: healthy volunteers; high altitude; hypoxia; microcirculation; septic shock.