División de Terapia Intensiva, Hospital Juan A. Fernández, Ciudad Autónoma de Buenos Aires, Buenos Aires.
Cátedra de Farmacología Aplicada, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata.
Curr Opin Crit Care. 2023 Jun 1;29(3):236-243. doi: 10.1097/MCC.0000000000001044. Epub 2023 Apr 10.
Devices for assessing microcirculation at the bedside have been a technological breakthrough in the critical care field. Thanks to this technology, a large body of scientific evidence has highlighted the relevance of microcirculatory disruptions during critical illness. The goal of this review is to analyze the current knowledge concerning microcirculation monitoring, mainly focused on clinically available devices.
New evidence in oxygenation monitoring, advances in hand-held vital microscopes, and improvements in laser-based techniques ensure the possibility of detecting poor resuscitation, testing vascular reactivity, and assessing the effect of therapy during shock and resuscitation.
Currently, there are several methods for microcirculatory monitoring. To properly apply and correctly interpret the information they provide, clinicians should know the fundamental principles and the strengths and weaknesses of the clinically available devices.
床边评估微循环的设备是重症监护领域的一项技术突破。得益于这项技术,大量科学证据强调了在危重病期间微循环紊乱的相关性。本综述的目的是分析目前关于微循环监测的知识,主要侧重于临床可用的设备。
在氧合监测方面的新证据、手持式生命显微镜的进步以及基于激光的技术的改进确保了检测复苏不良、测试血管反应性以及在休克和复苏期间评估治疗效果的可能性。
目前,有几种微循环监测方法。为了正确应用和正确解释它们提供的信息,临床医生应该了解基本原理以及临床可用设备的优缺点。