Physiology and technology hand in hand for clinical imaging of the microcirculation

Abstract

Given the growing interest in the study of microcirculation, we believe that an editorial comment about our article should be welcome. Unfortunately, we feel that the editorialists failed to understand our findings. Drs. Takala and Jakob raise some specific issues. First, they emphasize the high susceptibility ofthe model to hemorrhage, already addressed in the manuscript. Unfortunately, they fail to realize that reductions of 24% in cardiac output (CO) only marginally increased lactate (1.6 ± 0.3 to 2.4 ± 0.6 mmol/l) and had no effects on systemic and intestinal oxygen consumptions, blood pressure or base excess, while provoking clear microcirculatory changes. These, however, could be tracked non-invasively in the sublingual mucosa, rendering it a potential area for the clinical monitoring of hypoperfusion.