Septic shock reduces intestinal microcirculation and anastomotic perfusion: A porcine laser speckle contrast imaging study

Figure 1 Timeline for the porcine sepsis model. Overview of the study set-up and laser speckle contrast imaging measurement time points. T_B = Baseline measurements; T_A = Immediately after anastomosis formation; T₀ = After one hour of rest, start of Escherichia coli infusion; T₃₀, T₆₀, T₉₀, T₁₂₀, T₁₅₀ = Measurements taken at different time points, in minutes, during Escherichia coli infusion/sepsis. E. coli: Escherichia coli. Biorender.com was used for the design.

Figure 2 Laser speckle contrast imaging measurements of the anastomose for colon at specific time points. A: Colon hand-sewn; B: Colon stapled. The placement of regions of interest (ROIs) is indicated on all white light images using bold markings: ROIs were placed adjacent to each other, with ROI 1 centered on the anastomosis, ROI 2 ± 5 mm on either side, and ROI 3 ± 10 mm on either side of the anastomosis. A color scale ranging from red to blue indicates good to poor perfusion, respectively. T_A = Immediately after anastomosis formation; T₀ = One hour of rest/start of Escherichia coli (E. coli) infusion; T₆₀, T_120, T₁₅₀ = Measurements taken during E. coli infusion/sepsis, number indicates minutes from start of E. coli infusion.

Figure 3 Hemodynamic changes and sepsis variables in the porcine model. A: Shows the hemodynamic parameters measured throughout the experiment: Systolic blood pressure, mean arterial blood pressure, and pulse from start (right after anesthesia induction prior to surgery) to T₁₅₀. Following the initiation of the Escherichia coli (E. coli) infusion (at T0), hemodynamic parameters were recorded every 10 minutes. The Y-axis represents values in mmHg (for blood pressure and mean arterial pressure), beats per minute (for pulse). Whiskers represent SD; B: Illustrates the progression of pH and lactate levels throughout the duration of the experiment. The graph shows the mean value ± SD (whiskers). X-axis represents time points: Start = After induced anesthesia and prior to surgery; T_B = Baseline measurements; T_A = Immediately after anastomosis formation; T₃₀, T₆₀, T₉₀, T₁₂₀, T₁₅₀ = Measurements taken during E. coli infusion/sepsis, number indicates minutes from start of E. coli infusion. The Y-axis represents lactate levels in mmol/L, or pH values. SysBP: Systolic blood pressure; MAP: Mean arterial pressure; E. coli: Escherichia coli.

Figure 4 Graphical representation of the relative change in microcirculation over time compared to baseline. A: Colon hand-sewn; B: Colon stapled; C: Small intestine hand-sewn; D: Small intestine stapled. The Y-axis represents the relative change compared to baseline values. X-axis represents time points: T_B = Baseline measurements; T_A = Immediately after anastomosis formation; T₀ = After one hour of rest, start of Escherichia coli (E. coli) infusion; T₃₀, T₆₀, T₉₀, T₁₂₀, T₁₅₀ = Measurements taken during E. coli infusion/sepsis, number indicates minutes from start of E. coli infusion. ROI: Region of interest.