Microcirculation-guided resuscitation in sepsis: the next frontier?
نویسندگان
چکیده
Microcirculatory dysfunction plays a key role in the pathogenesis of tissue dysoxia and organ failure sepsis. Sublingual videomicroscopy techniques enable real-time non-invasive assessment microvascular blood flow. Alterations sublingual perfusion were detected during sepsis are associated with poor outcome. More importantly, allowed to explore effects commonly applied resuscitative treatments septic shock, such as fluids, vasopressors inotropes, showed that optimization macro-hemodynamic parameters may not be accompanied by an improvement perfusion. This loss “hemodynamic coherence,” i.e., concordance between response macrocirculation microcirculation, advocates for integration monitoring management patients. Nonetheless, important barriers remain widespread use clinical practice. In this review, we discuss actual limitations technique future developments allow easier faster evaluation microcirculation at bedside, propose guiding titrating therapies
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ژورنال
عنوان ژورنال: Frontiers in Medicine
سال: 2023
ISSN: ['2296-858X']
DOI: https://doi.org/10.3389/fmed.2023.1212321