3 results

How to choose the therapeutic goals to improve tissue perfusion in septic shock

Murillo Santucci Cesar de Assuncao, Thiago Domingos Corrêa, Bruno de Arruda Bravim, Eliézer Silva

DOI: 10.1590/S1679-45082015RW3148

The early recognition and treatment of severe sepsis and septic shock is the key to a successful outcome. The longer the delay in starting treatment, the worse the prognosis due to persistent tissue hypoperfusion and consequent development and worsening of organ dysfunction. One of the main mechanisms responsible for the development of cellular dysfunction is tissue hypoxia. The adjustments necessary for adequate tissue blood flow and therefore of oxygen supply to metabolic demand according to the assessment of the cardiac […]

Microcirculatory assessment in daily clinical practice – not yet ready but not too far!

Diamantino Ribeiro Salgado, Raphaël Favory, Daniel De Backer

DOI: 10.1590/s1679-45082010rw1311

ABSTRACTShock is characterized by an alteration in tissue perfusion that may lead to tissue hypoxia. Recent guidelines recommend aggressive and early resuscitation therapy, but mortality rate is still unacceptably high. Unfortunately, traditional clinical surrogates used to guide resuscitation therapy poorly correlate with microcirculatory blood flow, a key determinant of tissue perfusion. New techniques that directly assess microcirculatory perfusion at the bedside have emerged as a complement to traditional macrohemodynamic parameters. These techniques have been supported by several studies showing microcirculatory […]