Strategy focused on clinical parameters of microcirculation to resuscitate patients in septic shock: do not forget any tools

2019 
Editorial Strategy focused on clinical parameters of microcirculation to resuscitate patients in septic shock: Do not forget any tools The current objective of initial resuscitation of patients with septic shock is the optimisation of general haemodynamic variables including heart rate, mean arterial blood pressure, cardiac output and cardiac preload using normalisation of arterial lactate as a marker of presumed success. However, microcirculatory blood flow can remain impaired despite restoration of macro-haemodynamic parameters. Ait-Oufella et al. clearly showed that persistence of skin mottling], an increased capillary refill time (CRT) and an increased toe-to-room temperature gradient were associated with worse patient outcomes. Similarly, Leone et al. reported that low oxygen tissue saturation (StO 2) was associated with poor outcomes in patients with septic shock. Few studies have assessed a strategy targeting the microcirculation...
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