FACTORS IN TISSUE PERFUSION The microcirculation in shock
نویسنده
چکیده
Some aspects ofblood fluidity in hypoperfusion with particular reference to the important role of the red cell are discussed. Changes in different organ beds and the internal fluidity of the rcd cell, which is of obvious importance in capillary flow are not considered. It is not certain to what extent the phenomena discussed are critical factors in morbidity and mortality in shock because of paucity of objective data but there are good reasons for assuming them to be of importance and for directing treatment towards their correction. The properties of Dextran 40 applicable to the therapy of disordered blood fluidity are described.
منابع مشابه
Tissue saturation measurement - exciting prospects, but standardisation and reference data still needed
Sepsis and shock result in disturbances in microcirculatory perfusion and tissue oxygen utilisation that may not be reflected in global measures of haemodynamics. Near-infrared spectroscopy enables measurement of tissue oxygen saturation (StO2) and provides information on local microvascular and mitochondrial function. This measure could be incorporated with existing targets of goal-directed th...
متن کاملArterial blood pressure targets in septic shock: is it time to move to an individualized approach?
Xu and colleagues evaluated the impact of increasing mean arterial blood pressure levels through norepinephrine administration on systemic hemodynamics, tissue perfusion, and sublingual microcirculation of septic shock patients with chronic hypertension. The authors concluded that, although increasing arterial blood pressure improved sublingual microcirculation parameters, no concomitant improv...
متن کاملBench-to-bedside review: Sepsis is a disease of the microcirculation
Microcirculatory perfusion is disturbed in sepsis. Recent research has shown that maintaining systemic blood pressure is associated with inadequate perfusion of the microcirculation in sepsis. Microcirculatory perfusion is regulated by an intricate interplay of many neuroendocrine and paracrine pathways, which makes blood flow though this microvascular network a heterogeneous process. Owing to ...
متن کاملHemodynamic coherence and the rationale for monitoring the microcirculation.
This article presents a personal viewpoint of the shortcoming of conventional hemodynamic resuscitation procedures in achieving organ perfusion and tissue oxygenation following conditions of shock and cardiovascular compromise, and why it is important to monitor the microcirculation in such conditions. The article emphasizes that if resuscitation procedures are based on the correction of system...
متن کاملEffect of early goal directed therapy on tissue perfusion in patients with septic shock
BACKGROUND This study aimed to observe the effect of early goal directed therapy (EGDT) on tissue perfusion, microcirculation and tissue oxygenation in patients with septic shock. METHODS Patients with early septic shock (<24 hours) who had been admitted to the ICU of Zhongda Hospital Affiliated to Southeast University from September 2009 through May 2011 were enrolled (research time: 12 mont...
متن کاملRe-thinking resuscitation: leaving blood pressure cosmetics behind and moving forward to permissive hypotension and a tissue perfusion-based approach
Definitions of shock and resuscitation endpoints traditionally focus on blood pressures and cardiac output. This carries a high risk of overemphasizing systemic hemodynamics at the cost of tissue perfusion. In line with novel shock definitions and evidence of the lack of a correlation between macro- and microcirculation in shock, we recommend that macrocirculatory resuscitation endpoints, parti...
متن کامل