OBJECTIVE: A prominent feature of @entity295 is dysfunction of the microcirculation, with impaired perfusion and regional tissue oxygenation causing a deficit in @entity26 extraction. If shunting of @entity26 transport past closed @entity519 microcirculatory beds is responsible for this, vasodilator therapy, which raises the driving pressure of the microcirculation and thereby promotes flow, could recruit such shunted microcirculatory units and improve tissue oxygenation. DESIGN: A literature search was conducted in Medline for evidence of this expected benefit of vasodilators in @entity295 . METHODS: Studies were searched using the keyword for vasodilating drugs in combination with " @entity295 ," "septic," " @entity881 ," or " @entity3124 @entity1 ." The search included animal and clinical investigations but only where the effects of vasodilator therapy were demonstrated by regional measures of @entity26 transport variables (e.g., @entity26 extraction variables, regional @entity63 , microcirculatory flow or tissue oxygenation measurements). The vasodilating drugs investigated included @entity4770 , @entity1502 , @entity898 , and @entity842 donors used in animal and @entity1 @entity295 . RESULTS: @entity4770 and @entity842 donors are the best studied vasodilating agents in experimental @entity295 and have shown improved tissue perfusion and @entity26 extraction. In several clinical studies @entity4770 has also been shown to have such beneficial effects. Recent studies using orthogonal polarization spectral imaging have shown microcirculatory recruitment by @entity842 donors in hemodynamically resuscitated septic @entity1 . Whether such therapeutic modalities aimed at recruitment of the microcirculation improve outcome, however, still has to be determined.

Opening the microcirculation: can vasodilators be useful in XXXX ?

@entity1 :: ('9606', 'Species') :: ['human', 'patients'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity26 :: ('MESH:D010100', 'Chemical') :: ['oxygen'] @entity3124 :: ('MESH:D016638', 'Disease') :: ['critically ill'] @entity898 :: ('MESH:D000111', 'Chemical') :: ['N-acetyl-cysteine'] @entity4770 :: ('MESH:D011464', 'Chemical') :: ['Prostacyclin', 'prostacyclin'] @entity519 :: ('MESH:D000860', 'Disease') :: ['hypoxic'] @entity842 :: ('MESH:D009569', 'Chemical') :: ['nitric oxide'] @entity1502 :: ('MESH:D010431', 'Chemical') :: ['pentoxifylline'] @entity881 :: ('MESH:D009102', 'Disease') :: ['multiple organ failure']
@entity295 :: (MESH:D018805,Disease) :: ['sepsis']
