Hariri Geoffroy, Joffre Jérémie, Leblanc Guillaume, Bonsey Michael, Lavillegrand Jean-Remi, Urbina Tomas, Guidet Bertrand, Maury Eric, Bakker Jan, Ait-Oufella Hafid
Service de réanimation médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France.
Sorbonne Université, Université Pierre-et-Marie Curie-Paris 6, Paris, France.
Ann Intensive Care. 2019 Mar 13;9(1):37. doi: 10.1186/s13613-019-0511-1.
Sepsis is one of the main reasons for intensive care unit admission and is responsible for high morbidity and mortality. The usual hemodynamic targets for resuscitation of patients with septic shock use macro-hemodynamic parameters (hearth rate, mean arterial pressure, central venous pressure). However, persistent alterations of microcirculatory blood flow despite restoration of macro-hemodynamic parameters can lead to organ failure. This dissociation between macro- and microcirculatory compartments brings a need to assess end organs tissue perfusion in patients with septic shock. Traditional markers of tissue perfusion may not be readily available (lactate) or may take time to assess (urine output). The skin, an easily accessible organ, allows clinicians to quickly evaluate the peripheral tissue perfusion with noninvasive bedside parameters such as the skin temperatures gradient, the capillary refill time, the extent of mottling and the peripheral perfusion index.
脓毒症是入住重症监护病房的主要原因之一，且会导致高发病率和死亡率。感染性休克患者复苏的常用血流动力学目标采用宏观血流动力学参数（心率、平均动脉压、中心静脉压）。然而，尽管宏观血流动力学参数已恢复，但微循环血流持续改变仍可导致器官衰竭。宏观和微循环腔室之间的这种分离使得有必要评估感染性休克患者的终末器官组织灌注。传统的组织灌注标志物可能不易获得（乳酸）或评估需要时间（尿量）。皮肤是一个易于触及的器官，临床医生可以通过诸如皮肤温度梯度、毛细血管再充盈时间、斑纹程度和外周灌注指数等无创床边参数快速评估外周组织灌注。
