title: Microcirculatory alterations in shock states.
abstract: Functional components of the microcirculation provide oxygen and nutrients and remove waste products from the tissue beds of the body's organs. Shock states overwhelmingly stress functional capacity of the microcirculation, resulting in microcirculatory failure. In septic shock, inflammatory mediators contribute to hemodynamic instability. In nonseptic shock states, the microcirculation is better able to compensate for alterations in vascular resistance, cardiac output, and blood pressure. Therefore, global hemodynamic and oxygen delivery parameters are appropriate for assessing, monitoring, and guiding therapy in hypovolemic and cardiogenic shock but, alone, are inadequate for septic shock.
authors.affiliation: Nursing Research and Evidence-Based Practice, Houston Methodist Hospital, MGJ 11-017, Houston, TX 77030, USA. Electronic address: SHamlin@HoustonMethodist.org.
authors.forename: Shannan K
authors.initials: SK
authors.lastname: Hamlin
authors.affiliation: Vanderbilt University Hospital, 1211 21st Avenue South, S3408 MCN, Nashville, TN 37212, USA; Department of Anesthesiology, Division of Critical Care, Vanderbilt University School of Medicine, 1211 21st Avenue South, S3408 MCN, Nashville, TN 37212, USA.
authors.forename: C Lee
authors.initials: CL
authors.lastname: Parmley
authors.affiliation: Center for Nursing Research, University of Texas Health Science Center at Houston School of Nursing, Room #594, 6901 Bertner Avenue, Houston, TX 77030, USA.
authors.forename: Sandra K
authors.initials: SK
authors.lastname: Hanneman
mesh_terms: D001794:Blood Pressure; D002302:Cardiac Output; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008833:Microcirculation / Q000502:physiology*; D010100:Oxygen / Q000097:blood; D010101:Oxygen Consumption / Q000502:physiology; D012770:Shock, Cardiogenic / Q000628:therapy; D012772:Shock, Septic / Q000503:physiopathology*
chemical_list: D010100:Oxygen
keywords: Blood flow; Cardiogenic shock; Hypovolemic shock; Microcirculation; Oxygen extraction; Oxygen transport; Oxygen utilization; Septic shock