Microcirculation diagnostics and applied studies in circulatory shock - Research from the bench to the bedside

Abstract

Macrohemodynamic targets such as mean arterial pressure, cardiac output, and mixed or central venous oxygen saturation have been used to guide treatment of patients presenting circulatory shock. However, it has been shown that despite of improvement of macrocirculatory parameters there is persisting microcirculatory dysfunction.

The restoration of microvascular perfusion in order to improve oxygenation, prevent tissue hypoxia, and maintain organ function represents the main aim of hemodynamic resuscitation. Therefore, microcirculatory targets may represent the most important endpoints to optimize therapy of circulatory shock.

Keywords

• contrast-enhanced ultrasound
• goal-directed therapy
• balloon pump support
• care-unit patients
• septic shock
• hemorrhagic-shock
• microvascular flow
• cardiogenic-shock
• blood-viscosity
• endotoxin-shock