Noninvasive Bedside Approaches for Assessing Microvascular Dysfunction.

Area of Science:

• Physiology
• Biomedical Engineering
• Clinical Diagnostics

Background:

• Microvascular dysfunction is a key factor in acute and chronic diseases, often preceding organ damage.
• Compromised microcirculation in conditions like diabetes and septic shock correlates with disease severity and patient outcomes.
• Early and accurate assessment of microvascular function is vital for timely intervention.

Purpose of the Study:

• To review clinically feasible, non-invasive techniques for evaluating microvascular function.
• To highlight the potential of advanced technologies like AI and novel imaging in microvascular assessment.
• To discuss the current limitations and future directions for clinical application of these methods.

Main Methods:

• Overview of non-invasive techniques: optical coherence tomography angiography, handheld videomicroscopy, laser speckle contrast imaging, and reflectance spectroscopy.
• Description of functional tests: post-occlusive reactive hyperemia, heating provocation, and iontophoresis.
• Emphasis on combining resting condition observations with functional assessments.

Main Results:

• These non-invasive methods offer valuable insights into microcirculation structure and function.
• Current clinical application is limited by the need for standardized protocols and validation.
• Evidence linking microvascular metrics to patient outcomes is still developing.

Conclusions:

• Non-invasive bedside techniques for microvascular assessment are rapidly evolving.
• Standardization, validation, and clinical outcome evidence are crucial for widespread adoption.
• Collaborative efforts are needed to translate these technologies into regulated clinical devices.