[Assessment of microcirculation in critically ill patients]

Adequate organ supply of oxygen and of nutrients depends on microcirculation. Impaired microcirculation may result in temporary or irreversible loss of function. Therefore, critically ill patients require early diagnosis and therapy of microcirculatory disorders. Besides surrogate parameters of microcirculation like urine production or serum lactate levels, direct visualization became possible with sidestream darkfield intravital microscopy. This technique has been evaluated in clinical studies focusing on early diagnosis and therapy in cardiogenic shock like vasopressors, nitrates, or circulatory assist devices. Further studies evaluating measurements of microcirculation are necessary before a general recommendation for its routine use can be made.