Narrative review: clinical assessment of peripheral tissue perfusion in septic shock

Annals of Intensive Care

Jan Bakker¹  Guillaume Leblanc²  Eric Maury³  Jérémie Joffre³  Tomas Urbina³  Michael Bonsey³  Jean-Remi Lavillegrand³  Hafid Ait-Oufella³  Geoffroy Hariri³  Bertrand Guidet³ 

[1] Department Intensive Care Adults, Erasmus MC University Medical Center;Division of Critical Care Medicine, Department of Anesthesiology and Critical Care Medicine, Université Laval;Service de réanimation médicale, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine;

关键词: Septic shock;    Microcirculation;    Capillary refill time;    Temperatures gradient;    Peripheral perfusion index;    Mottling;   

DOI  :  10.1186/s13613-019-0511-1

来源: DOAJ

【 摘 要 】

Abstract Sepsis is one of the main reasons for intensive care unit admission and is responsible for high morbidity and mortality. The usual hemodynamic targets for resuscitation of patients with septic shock use macro-hemodynamic parameters (hearth rate, mean arterial pressure, central venous pressure). However, persistent alterations of microcirculatory blood flow despite restoration of macro-hemodynamic parameters can lead to organ failure. This dissociation between macro- and microcirculatory compartments brings a need to assess end organs tissue perfusion in patients with septic shock. Traditional markers of tissue perfusion may not be readily available (lactate) or may take time to assess (urine output). The skin, an easily accessible organ, allows clinicians to quickly evaluate the peripheral tissue perfusion with noninvasive bedside parameters such as the skin temperatures gradient, the capillary refill time, the extent of mottling and the peripheral perfusion index.

【 授权许可】

Unknown