Micro-circulating hyperdynamic blood flow as a key pathogenic factor in early sepsis

Objective The pathogenesis of sepsis is still unknown. Sepsis 3.0 points out that “how to define sepsis and septic shock itself is still a challenge”. This study confirmed the inevitability and universality of Hyperdynamic microcirculation in sepsis, and put forward the detoxification mechanism of Hyperdynamic blood flow and the “Xinghuai Feng-Bernoulli warm shock” mechanism, that is, the pathogenic mechanism of sepsis. Methods Sepsis models of pigs, rabbits, Mice, rats and sheep were established by intravenous injection of lipopolysaccharide (LPS) and cecal ligation and perforation (CLP), and the changes of sublingual microcirculation velocity in the same branch before and after modeling were detected. SD rat model of mild sepsis was established to verify that the acceleration of blood flow is the manifestation of immune detoxification mechanism. Results The blood flow in the same branch was accelerated after the animal sepsis model was established, which was more than doubled on average. The microcirculation blood flow accelerated before the change of cardiac output CO. Rats entered a toxic state after the rapid blood flow occurred, but they could heal themselves. Conclusion The acceleration of microcirculation blood flow in sepsis is inevitable and universal, which is the cause of high output and low resistance of sepsis, and has the functions of accelerating detoxification and immunity. However, due to Bernoulli effect, it will cause oxygen exchange disorder, which is named “Xinghuai Feng-Bernoulli warm shock”, ultimately leading to hypoxia. This is the primary pathogenic mechanism of early sepsis. Since the completion of this article in 2023, its principles have undergone multicenter, randomized, and double-blind clinical verification, achieving satisfactory results. The specifics will have to wait for the publication by the three Class A tertiary hospitals.