Ferrari M, Jung C, Lauten A, Pfeifer R, Figulla H R
Klinik für Innere Medizin 1, Universitätsherzzentrum Thüringen, Friedrich-Schiller-Universität, Jena.
Dtsch Med Wochenschr. 2011 May;136(19):1009-13. doi: 10.1055/s-0031-1275835. Epub 2011 May 3.
The microcirculatory status depicts an indicator of organ perfusion in hemodynamic shock. Distribution pattern of microcirculatory disturbances reflects the underlying cause of shock: In septic shock, organ perfusion is severely impaired via arteriolo-venous shunting with shutting up small vessel perfusion; however, cardiogenic shock is characterized by a global impairment of microcirculation, involving all vascular beds. Hence, a differentiated evaluation of microcirculatory disturbances not only supports an early diagnosis of an imminent multiorgan dysfunction syndrome (MODS), but also allows a more accurate evaluation of severity of hemodynamic compromise in critical care medicine. Bedside sidestream darkfield (SDF) technique offers the opportunity to describe the microcirculatory status quo semiquantitatively and to evaluate the effect of novel therapeutic approaches on microcirculation. Further technical improvements of this technique may open new fields of diagnostic and therapeutic applications in intensive care medicine by supporting an early diagnosing of MODS, evaluating prognosis, and optimizing therapeutic measures .
微循环状态是血流动力学休克中器官灌注的一个指标。微循环障碍的分布模式反映了休克的潜在原因：在感染性休克中，器官灌注通过动静脉分流严重受损，导致小血管灌注关闭；然而，心源性休克的特征是微循环的整体受损，累及所有血管床。因此，对微循环障碍进行差异化评估不仅有助于早期诊断即将发生的多器官功能障碍综合征（MODS），还能更准确地评估重症医学中血流动力学损害的严重程度。床旁侧流暗视野（SDF）技术提供了半定量描述微循环现状并评估新型治疗方法对微循环影响的机会。该技术的进一步技术改进可能通过支持MODS的早期诊断、评估预后和优化治疗措施，在重症医学中开辟诊断和治疗应用的新领域。
