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Updated: Jul 1, 2025

Real-Time Assessment of Spinal Cord Microperfusion in a Porcine Model of Ischemia/Reperfusion

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Resuscitating the macro- vs. microcirculation in septic shock.

Rafael González^1,2,3,4, Javier Urbano^1,2,3,4, Jesús López-Herce^1,2,3,4

¹Pediatric Intensive Care Department, Hospital General Universitario Gregorio Marañón.

Current Opinion in Pediatrics

|March 6, 2024

Summary

Septic shock in children requires tailored monitoring as improvements in macrocirculation do not always reflect microcirculation changes. Integrating macro, microcirculation, and metabolic monitoring is crucial for effective treatment.

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Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs

Standardized Hemorrhagic Shock Induction Guided by Cerebral Oximetry and Extended Hemodynamic Monitoring in Pigs

Published on: May 21, 2019

Area of Science:

Pediatric critical care medicine
Hemodynamics
Septic shock research

Background:

Septic shock management in children presents variable treatment responses.
Macrocirculatory improvements do not consistently correlate with microcirculatory status during resuscitation.
Hemodynamic coherence is often lost in pediatric septic shock.

Purpose of the Study:

To review the relationship between macro and microcirculation in pediatric septic shock.
To discuss the clinical implications of these circulatory dynamics.
To highlight the need for advanced monitoring strategies.

Main Methods:

Literature review of experimental and clinical observational studies.
Analysis of hemodynamic coherence between macro and microcirculation.
Evaluation of current monitoring parameters in septic shock.

Main Results:

Resuscitation responses in septic shock are highly variable.
Macrocirculatory improvements do not guarantee microcirculatory recovery.
Optimal monitoring requires integration of macrocirculatory, microcirculatory, and cellular metabolic parameters.

Conclusions:

Patient-tailored monitoring is essential for adjusting septic shock treatment.
There is a need for high-quality studies on macrocirculation, microcirculation, and metabolism in pediatric septic shock.
Development of novel biomarkers for microcirculation and tissue perfusion is necessary.