The state of microcirculation in the lower extremities in patients with sepsis complicated by complicated diabetic foot syndrome

Abstract

Objective. To study lower limb blood flow parameters in patients with sepsis against the background of complicated diabetic foot syndrome using laser Doppler flowmetry.

Materials and Methods. A total of 126 patients with sepsis caused by complicated diabetic foot syndrome were examined. All patients were treated at the city purulent-septic center with “diabetic foot beds” at Zaporizhzhia City Hospital No. 4 between 2005 and 2025. The cause of sepsis in 115 (91.3%) patients was “wet” gangrene of the lower extremities. In the remaining 11 (8.7%) patients, sepsis developed due to phlegmon and widespread osteomyelitis of the foot. All patients underwent surgery under general anesthesia. Additionally, a control group of 18 healthy individuals was formed for participation in the study. Microcirculation was assessed using laser Doppler flowmetry with the LAKK-02 analyzer (LAZMA Scientific and Production Enterprise LLC).

Results. In patients with sepsis complicated by diabetic foot syndrome, the mean blood flow rate—as a constant component of blood circulation—was (9.23 ± 0.54) perfusion units, which was three times higher than the corresponding control value; this difference was statistically significant (p < 0.05). The increase in the mean perfusion index indicated an increase in blood volume in the arterioles and venules. The mean perfusion fluctuation index, as a variable component of blood circulation, was (1.4 ± 0.22) perfusion units and was 2 times higher than the control values (p < 0.05). This indicated increased modulation of blood circulation and more intensive functioning of the mechanisms of active microcirculation control. The coefficient of variation was (17.65 ± 1.69)% and was 2 times lower than control values, with a statistically significant difference (p < 0.05). This reflected a deterioration in microcirculation.

Conclusions. The use of laser Doppler flowmetry in patients with sepsis against the background of complicated diabetic foot syndrome allows for obtaining reliable data on the state of the microcirculatory bed of the lower extremities.