Status of the Bronchial Microcirculatory Bed in Patients with Severe Community-Acquired Pneumonia
https://doi.org/10.22448/AMJ.2025.2.30-35
EDN: QGGUCO
Abstract
Objective: To assess the state of the microcirculatory bed in the bronchial mucosa of patients with severe community-acquired pneumonia (SCAP) and its association with systemic inflammation markers.
Materials and methods: The prospective study included 40 patients with SCAP. The control group consisted of 20 apparently healthy volunteers. Microcirculation in the main bronchial mucosa was evaluated by laser Doppler flowmetry upon admission and on day 14 of therapy. Perfusion (M) and amplitudes of vasomotor oscillations were analyzed. Data are presented as mean±standard deviation (M±SD). Intergroup comparisons were performed using the Mann–Whitney U test; correlations were assessed using Spearman’s rank correlation coefficient. Statistical significance was set at p<0.05.
Results: On admission, SCAP patients exhibited a statistically significant reduction in perfusion to 14.5±2.8 perfusion units (PU), compared to 25.1±3.5 PU in controls (p<0.001). Suppression of the endothelial component of vasomotion amplitude was also observed (p<0.01), indicating endothelial dysfunction. After 14 days of treatment, perfusion increased to 21.3±3.2 PU (p<0.05). An inverse correlation was found between baseline perfusion and C-reactive protein (CRP) concentration (r= -0.58; p<0.05).
Conclusion: SCAP is associated with marked disturbances in bronchial microcirculation that correlate with the intensity of systemic inflammation. Laser Doppler flowmetry is an informative tool for monitoring local hemodynamic impairments and evaluating therapeutic efficacy.
About the Authors
O. A. Abuldinova
Amur State Medical Academy of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Olga A. Abuldinova
Blagoveshchensk
A. S. Abuldinov
Amur State Medical Academy of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Anton S. Abuldinov
Blagoveshchensk
O. B. Prikhodko
Amur State Medical Academy of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Olga B. Prikhodko
Blagoveshchensk
References
1. Metlay J.P., Waterer G.W., Long A.C, et al. Diagnosis and Treatment of Adults with Community-acquired Pneumonia. An Official Clinical Practice Guideline of the American Thoracic Society and Infectious Diseases Society of America. American Journal of Respiratory and Critical Care Medicine. 2019; 200 (7): e45–e67. DOI: https://doi.org/10.1164/rccm.201908-1581ST
2. Torres A., Cilloniz C., Niederman M.S., et al. Pneumonia. Nature Reviews Disease Primers. 2021; 7 (1): 25. DOI: https://doi.org/10.1038/s41572-021-00259-0
3. Ince C., Boerma E.C., Cecconi M., et al. Second consensus on the assessment of sublingual microcirculation in critically ill patients: results from a task force of the European Society of Intensive Care Medicine. Intensive Care Medicine. 2018; 44 (3): 281–299. DOI: https://doi.org/10.1007/s00134-017-5040-5
4. Joffre J., Hellman J., Ince C., Ait-Oufella H. Endothelial Responses in Sepsis. American Journal of Respiratory and Critical Care Medicine. 2020; 202 (3): 361–370. DOI: https://doi.org/10.1164/rccm.201910-1911TR
5. Singer M., Deutschman C.S., Seymour C.W., et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016; 315 (8): 801–810. DOI: https://doi.org/10.1001/jama.2016.0287
6. Luck J.C., Kunselman A.R., Herr M.D., et al. Multiple Laser Doppler Flowmetry Probes Increase the Reproducibility of Skin Blood Flow Measurements. Front Physiol. 2022; 13: 876633. DOI: https://doi.org/10.3389/fphys.2022.876633
7. Martin-Loeches I., Torres A., Nagavci B., et al. ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia. Intensive Care Med. 2023; 49 (6): 615–632. DOI: https://doi.org/10.1007/s00134-023-07033-8
8. Tang F., Zhao X.L., Xu L.Y., et al. Endothelial dysfunction: Pathophysiology and therapeutic approaches in sepsis. Biomed Pharmacother. 2024; 178: 117180. DOI: https://doi.org/10.1016/j.biopha.2024.117180
9. Nickl R., Haberl S., Pietzsch J., Richter T. Significance of Pulmonary Endothelial Injury and the Role of Cyclooxygenase-2 and Prostanoid Signaling. International Journal of Molecular Sciences. 2023; 10 (1): 117. DOI: https://doi.org/10.3390/bioengineering10010117
10. Gong W., Gao K., Shan Z., et al. Research progress of biomarkers in evaluating the severity and prognosis of community-acquired pneumonia in children. Frontiers in Pediatrics. 2024; 12: 1417644. DOI: https://doi.org/10.3389/fped.2024.1417644
11. Zhang T.N., Huang X.M., Goodwin J.E., et al. Endothelial CLEC5A drives barrier dysfunction and vascular leakage responsible for lung injury in bacterial pneumonia and sepsis. Science Advances. 2024; 11 (22): eadt7589. DOI: https://doi.org/10.1126/sciadv.adt7589
12. Eaton D.C., Romero M.J., Matthay M.A., et al. Endothelial ENaC as a repressor of oxidative stress and vascular inflammation in sepsis and acute respiratory distress syndrome. Frontiers in Physiology. 2025; 16: 1562626. DOI: https://doi.org/10.3389/fphys.2024.1330825
13. Abuldinova O.A., Prikhodko O.B., Abuldinov A.S. Dynamics of Functional Parameters of the Respiratory System in Patients with Various Forms of COVID-19. Public Health of the Far East. 2025; 2 (104): 20–25. DOI: https://doi.org/10.33454/1728-1261-2025-2-20-25 (In Russ.)
Review
For citations:
Abuldinova O.A., Abuldinov A.S., Prikhodko O.B. Status of the Bronchial Microcirculatory Bed in Patients with Severe Community-Acquired Pneumonia. Amur Medical Journal. 2025;13(2):30-35. (In Russ.) https://doi.org/10.22448/AMJ.2025.2.30-35. EDN: QGGUCO
Views:
6
JATS XML
Email this article 