From Macrohemodynamic to the Microcirculation
ICU patients need a prompt normalization of macrohemodynamic parameters. Unfortunately, this optimization sometimes does not protect patients from organ failure development. Prevention or treatment of organ failure needs another target to be pursued: the microcirculatory restoration. Microcirculati...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2013-01-01
|
| Series: | Critical Care Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2013/892710 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850225435453947904 |
|---|---|
| author | Abele Donati Roberta Domizi Elisa Damiani Erica Adrario Paolo Pelaia Can Ince |
| author_facet | Abele Donati Roberta Domizi Elisa Damiani Erica Adrario Paolo Pelaia Can Ince |
| author_sort | Abele Donati |
| collection | DOAJ |
| description | ICU patients need a prompt normalization of macrohemodynamic parameters.
Unfortunately, this optimization sometimes does not protect patients from organ failure development. Prevention or treatment of organ failure needs another target to be pursued: the microcirculatory restoration. Microcirculation is the ensemble of vessels of maximum 100 m in diameter.
Nowadays the Sidestream Dark Field (SDF) imaging technique allows its bedside investigation and a recent round-table conference established the criteria for its evaluation. First, microcirculatory derangements have been studied in sepsis: they are mainly characterized by a reduction of vessel density, an alteration of flow, and a heterogeneous distribution of perfusion. Endothelial malfunction and glycocalyx rupture were proved to be the main reasons for the observed microthrombi, capillary leakage, leukocyte rolling, and rouleaux phenomenon, even if further studies are necessary for a better explanation. Therapeutic approaches targeting microcirculation are under investigation. Microcirculatory alterations have been recently demonstrated in other diseases such as hypovolemia and cardiac failure but this issue still needs to be explored. The aim of this paper is to gather the already known information, focus the reader’s attention on the importance of microvascular physiopathology in critical illness, and prompt him to actively participate to achieve a more comprehensive understanding of the issue. |
| format | Article |
| id | doaj-art-593ba5e2360944cd8f8d201a3c7d4161 |
| institution | OA Journals |
| issn | 2090-1305 2090-1313 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Critical Care Research and Practice |
| spelling | doaj-art-593ba5e2360944cd8f8d201a3c7d41612025-08-20T02:05:21ZengWileyCritical Care Research and Practice2090-13052090-13132013-01-01201310.1155/2013/892710892710From Macrohemodynamic to the MicrocirculationAbele Donati0Roberta Domizi1Elisa Damiani2Erica Adrario3Paolo Pelaia4Can Ince5Sezione di Anestesia e Rianimazione, Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, Ancona, Via Tronto 10, 60020 Torrette (Ancona), ItalySezione di Anestesia e Rianimazione, Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, Ancona, Via Tronto 10, 60020 Torrette (Ancona), ItalySezione di Anestesia e Rianimazione, Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, Ancona, Via Tronto 10, 60020 Torrette (Ancona), ItalySezione di Anestesia e Rianimazione, Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, Ancona, Via Tronto 10, 60020 Torrette (Ancona), ItalySezione di Anestesia e Rianimazione, Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, Ancona, Via Tronto 10, 60020 Torrette (Ancona), ItalyDepartment of Translational Physiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The NetherlandsICU patients need a prompt normalization of macrohemodynamic parameters. Unfortunately, this optimization sometimes does not protect patients from organ failure development. Prevention or treatment of organ failure needs another target to be pursued: the microcirculatory restoration. Microcirculation is the ensemble of vessels of maximum 100 m in diameter. Nowadays the Sidestream Dark Field (SDF) imaging technique allows its bedside investigation and a recent round-table conference established the criteria for its evaluation. First, microcirculatory derangements have been studied in sepsis: they are mainly characterized by a reduction of vessel density, an alteration of flow, and a heterogeneous distribution of perfusion. Endothelial malfunction and glycocalyx rupture were proved to be the main reasons for the observed microthrombi, capillary leakage, leukocyte rolling, and rouleaux phenomenon, even if further studies are necessary for a better explanation. Therapeutic approaches targeting microcirculation are under investigation. Microcirculatory alterations have been recently demonstrated in other diseases such as hypovolemia and cardiac failure but this issue still needs to be explored. The aim of this paper is to gather the already known information, focus the reader’s attention on the importance of microvascular physiopathology in critical illness, and prompt him to actively participate to achieve a more comprehensive understanding of the issue.http://dx.doi.org/10.1155/2013/892710 |
| spellingShingle | Abele Donati Roberta Domizi Elisa Damiani Erica Adrario Paolo Pelaia Can Ince From Macrohemodynamic to the Microcirculation Critical Care Research and Practice |
| title | From Macrohemodynamic to the Microcirculation |
| title_full | From Macrohemodynamic to the Microcirculation |
| title_fullStr | From Macrohemodynamic to the Microcirculation |
| title_full_unstemmed | From Macrohemodynamic to the Microcirculation |
| title_short | From Macrohemodynamic to the Microcirculation |
| title_sort | from macrohemodynamic to the microcirculation |
| url | http://dx.doi.org/10.1155/2013/892710 |
| work_keys_str_mv | AT abeledonati frommacrohemodynamictothemicrocirculation AT robertadomizi frommacrohemodynamictothemicrocirculation AT elisadamiani frommacrohemodynamictothemicrocirculation AT ericaadrario frommacrohemodynamictothemicrocirculation AT paolopelaia frommacrohemodynamictothemicrocirculation AT canince frommacrohemodynamictothemicrocirculation |