Microcirculatory dysfunction and resuscitation: why, when, and how.
Cardiovascular resuscitation is a cornerstone of critical care practice. Experimental advances have increased our understanding of the role of the microcirculation in shock states and the development of multi-organ failure. Strategies that target the microcirculation in such conditions, while theoretically appealing, have not yet been shown to impact upon clinical outcomes. This review outlines the current understanding of microcirculatory dysfunction in septic, cardiogenic, and hypovolaemic shock and outlines available treatments and strategies with reference to their effects upon the microcirculation.
The School of Medicine, The University of Queensland, 288 Herston Road, Herston, Brisbane, QLD 4006, Australia Critical Care Research Group, The Prince Charles Hospital, Rode Road, Brisbane, QLD 4032, Australia Nambour General Hospital, Hospital Road, Nambour, QLD 4560, Australia john.moore@health.qld.gov.au.
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JP
Moore
Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, Cruciform Building, Gower Street, London WC1E 6BT, UK.
A
A
Dyson
Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, Cruciform Building, Gower Street, London WC1E 6BT, UK.
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M
Singer
The School of Medicine, The University of Queensland, 288 Herston Road, Herston, Brisbane, QLD 4006, Australia Critical Care Research Group, The Prince Charles Hospital, Rode Road, Brisbane, QLD 4032, Australia.
J
J
Fraser
D003422:Critical Care / Q000379:methods*; D006801:Humans; D008833:Microcirculation / Q000502:physiology*; D012151:Resuscitation / Q000379:methods*; D012769:Shock / Q000503:physiopathology* / Q000628:therapy*
blood, flow; complications, multiple organ dysfunction syndrome; intensive care, CVS; microcirculation; resuscitation