Microcirculation in anaesthesia: What every anaesthesiologist should know?
Stanislas Abrard1, Matthias Jacquet-Lagrèze2, Philippe Guerci3
1Department of Anesthesiology and Critical Care Medicine, Hospices Civils de Lyon, Edouard Herriot Hospital, 5 Place d'Arsonval, 69437 Lyon, France; Adult Intensive Care Division, Hôpitaux Universitaires de Genève, rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; Department of Anesthesiology, Hôpitaux Universitaires de Genève, rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; Faculté de Médecine Lyon-Est, Université Claude Bernard Lyon 1, 8 Avenue Rockefeller, 69003 Lyon, France.
Abstract:
Advances in knowledge have significantly enhanced our understanding of the structure and function of microcirculation. The tools used to study microcirculation have been refined and diversified. This review presents existing tools for anaesthesiologists and highlights two key areas where microcirculatory knowledge can be applied in anaesthesia: perioperative hemodynamic management and preoperative patient assessment. Preoperative microcirculatory assessment can identify dysfunction associated with chronic conditions and predict perioperative outcomes. This information allows for personalised patient management, improved counselling, and anticipation of postoperative complications. Intraoperatively, microcirculation monitoring provides valuable insights into tissue perfusion, guiding hemodynamic targets and fluid management. Despite its promising potential, integrating microcirculation monitoring into anaesthesia clinical practice presents challenges. Further research is needed to determine its prognostic value, refine monitoring tools, and validate the impact of microcirculation-focused interventions on patient outcomes.
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