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• W3016070418 abstract "Patient survival depends on determining the cause of the underlying condition and treating the pathology, as well as supportive care until restoration of normal physiology. Resuscitation guidelines have long been focused on macrohemodynamic variables, such as cardiac output, as well as indirect measures of blood flow and tissue perfusion, such as lactate. In recent years, interest has been developing in the assessment and management of the microcirculation. The early goals of resuscitation in circulatory shock are to restore global blood flow, oxygen delivery, and organ perfusion pressure with the ultimate aim of improving microcirculatory perfusion and cellular oxygen metabolism. The aim of this chapter is to outline the principles of the microcirculation, microcirculatory dysfunction in sepsis, and therapies to improve microcirculatory function and tissue perfusion. Sepsis is characterized by macrocirculatory alterations such as relative hypovolemia, a decrease in vascular tone, myocardial depression, a heterogeneous pattern of blood flow in microcirculation, as well as the incapacity of cells to extract and adequately use oxygen. With newer and more sophisticated monitoring techniques, the microcirculation can be used to guide resuscitative efforts towards more targeted therapies. In addition to clinical examination and biochemical markers as methods of assessment, handheld vital microscopes allow direct visualization of capillaries and a number of indices and classifications have been developed which show good inter-observer reproducibility. Despite the advances in our understanding of microcirculatory dysfunction there remains a deficit in knowledge regarding how best to treat it." @default.
• W3016070418 created "2020-04-17" @default.
• W3016070418 creator A5006690342 @default.
• W3016070418 creator A5034004394 @default.
• W3016070418 date "2020-01-01" @default.
• W3016070418 modified "2023-09-24" @default.
• W3016070418 title "Microcirculation in Patients with Sepsis: From Physiology to Interventions" @default.
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• W3016070418 doi "https://doi.org/10.1007/978-3-030-37323-8_20" @default.
• W3016070418 hasPublicationYear "2020" @default.
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