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| http://dx.doi.org/10.1007/s00134-023-07245-y | DOI Listing |
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A microcirculation-guided trial: never trying is worse than failing.
Intensive Care Med
December 2023
Department of Cardiology, Pulmonology and Vascular Medicine, Heinrich-Heine-University Duesseldorf, Medical Faculty, Moorenstraße 5, 40225, Duesseldorf, Germany.
A microcirculation-guided trial doomed to fail.
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Department of Intensive Care, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Lactate and microcirculation as suitable targets for hemodynamic optimization in resuscitation of circulatory shock.
Curr Opin Crit Care
August 2017
aDepartment of Anesthesiology bDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University Medical Center, NewYork-Presbyterian Hospital cDepartment of Pulmonary and Critical Care, Langone Medical Center-Bellevue Hospital, New York University, New York, New York, USA dDepartment of Intensive Care Adults, Erasmus MC University Medical Center, Rotterdam, The Netherlands eFacultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Purpose Of Review: A discussion of recent research exploring the feasibility of perfusion-guided resuscitation of acute circulatory failure with a focus on lactate and microcirculation.
Recent Findings: Upon diagnosis of shock, hyperlactemia is associated with poor outcome and, under appropriate clinical circumstances, may reflect inadequate tissue perfusion. Persistent hyperlactemia despite resuscitation is even more strongly correlated with morbidity and mortality.
Targeting the microcirculation in resuscitation of acutely unwell patients.
Curr Opin Crit Care
June 2011
Assistance Publique - Hôpitaux de Paris, Hôpital Bicêtre, Département d'Anesthésie-Réanimation, Université Paris Sud XI, Le Kremlin-Bicêtre, France.
Purpose Of Review: The ultimate goals of hemodynamic therapy in acutely unwell patients are to restore effective tissue perfusion and oxygen delivery to maintain cellular metabolism. Optimization of systemic hemodynamics may improve the time course of microcirculatory dysfunction and eventually the patient's outcome. However, relationships between systemic hemodynamics and microcirculatory changes during resuscitation are complex and underperfused microcirculation may persist, despite restored macrohemodynamics.
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