[Assessment of microcirculation in critically ill patients].
Adequate organ supply of oxygen and of nutrients depends on microcirculation. Impaired microcirculation may result in temporary or irreversible loss of function. Therefore, critically ill patients require early diagnosis and therapy of microcirculatory disorders. Besides surrogate parameters of microcirculation like urine production or serum lactate levels, direct visualization became possible with sidestream darkfield intravital microscopy. This technique has been evaluated in clinical studies focusing on early diagnosis and therapy in cardiogenic shock like vasopressors, nitrates, or circulatory assist devices. Further studies evaluating measurements of microcirculation are necessary before a general recommendation for its routine use can be made.
Medizinische Fakultät, Klinik für Kardiologie, Pulmonologie und Angiologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland. christian.jung@med.uni-duesseldorf.de.
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Jung
Medizinische Fakultät, Klinik für Kardiologie, Pulmonologie und Angiologie, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland.
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Kelm
HELIOS Dr. Horst Schmidt Kliniken Wiesbaden, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland.
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Ferrari
D016638:Critical Illness; D006439:Hemodynamics; D006801:Humans; D008833:Microcirculation; D010100:Oxygen; D012770:Shock, Cardiogenic
D010100:Oxygen
Blood circulation; Hemodynamics; Monitoring; Multiple organ failure; Shock