Related Experiment Video
Updated: Dec 11, 2025
07:51
Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs
Published on: May 21, 2019
7.7K
Early Sequential Microcirculation Assessment In Shocked Patients as a Predictor of Outcome: A Prospective
Anthony D Holley1,2,3, Joel Dulhunty1,2,4,5, Andrew Udy6,7
1Intensive Care Services, Royal Brisbane and Women's Hospital, Queensland, Australia.
Shock (Augusta, Ga.)
|August 23, 2020
Summary
Early microcirculation improvement in shock patients did not predict outcomes. While sublingual microcirculation parameters like Percentage Perfused Vessels (PPV) improved with standard care, this did not correlate with reduced organ injury or mortality.
Area of Science:
- Critical Care Medicine
- Hemodynamics
- Microcirculation Research
Background:
- Microcirculatory dysfunction is a hallmark of shock, often independent of global hemodynamic measures.
- Persistent microcirculatory derangements indicate ongoing tissue hypoperfusion and organ damage.
- Understanding early microcirculatory changes may guide therapy and prognostication in shock.
Purpose of the Study:
- To evaluate the early microcirculation in a diverse group of shocked patients.
- To correlate microcirculatory resolution with tissue perfusion and global hemodynamics.
- To assess the relationship between microcirculation over 24 hours and patient outcomes.
Main Methods:
- Prospective recruitment of patients with all forms of shock.
- Sublingual microcirculation examination using Sidestream Dark Field Imaging.
- Collection of microcirculatory parameters (PPV, De Backer Score, heterogeneity index) and physiological data.
Main Results:
- Statistically significant improvement in Percentage Perfused Vessels (PPV) and heterogeneity index observed.
- Microcirculatory improvements were mirrored by perfusion biomarkers.
- Global hemodynamic parameters did not show significant changes over 24 hours.
Conclusions:
- Standard care led to early microcirculatory improvements in shocked patients.
- These microcirculatory changes did not predict clinical outcomes such as acute kidney injury or mortality.
- Early microcirculatory assessment may not be a reliable predictor of short-term outcomes in heterogeneous shock populations.
