ArticleCritical care (London, England)2015
Hemodynamic coherence and the rationale for monitoring the microcirculation.
Article in Critical care (London, England), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 5 registered trials, which are not on this map. Cited by 298 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Improving the Assessment of Microcirculatory Dysfunction in Septic Shock Patients Using Optical Coherence Tomography Angiography at the Bedside
Capillary Refill Time Response to a Rapid Fluid Challenge in Septic Shock Patients: Pathophysiological Determinants, and Relation to Changes in Systemic, Regional and Microcirculatory Blood Flow
The Prognostic Value of Simultaneous Assessment of Microcirculation Alteration With Sublingual Microcirculation and Near-infrared Spectroscopy on the Acute Respiratory Distress Syndrome of Various Phenotypes
Improving Microcirculation and Microvascular Leakage in Sepsis Patients: A Comprehensive Clinical Study of Shenfu Injection
Efficacy and Safety of Balanced Gelatin Solution for Fluid Infusion in Sepsis Patients Undergoing Emergency Abdominal Surgery: A Multicenter, Adaptive Designed, Randomized Controlled Trial
Who cites it
298 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Meta-Analysis of the Prognostic Value of Skin Perfusion Parameters in Sepsis Patients: Evidence Integration Based on the Mottling Score, Capillary Refill Time, and Peripheral Perfusion Index.Shock (Augusta, Ga.) · 2026Pooled it
- Beta-blocker treatment in the critically ill: a systematic review and meta-analysis.Annals of medicine · 2022Pooled it
- The use of a vascular occlusion test combined with near-infrared spectroscopy in perioperative care: a systematic review.Journal of clinical monitoring and computing · 2022Pooled it
- Acute effects of energy drink consumption on microvascular reactivity in young male volunteers at rest: a randomized trial.Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologica · 2024Trial
- Description of mitochondrial oxygen tension and its variability in healthy volunteers.PloS one · 2024Trial
- Effect of high-dose intravenous ascorbic acid on microcirculation and endothelial glycocalyx during sepsis and septic shock: a double-blind, randomized, placebo-controlled study.BMC anesthesiology · 2023Trial
- Addition of terlipressin to norepinephrine in septic shock and effect of renal perfusion: a pilot study.Renal failure · 2022Trial
- Sepsis-associated endothelial dysfunction: clinical phenotypes, biomarkers, bedside evidence, and translational implications.The Journal of clinical investigation · 2026Review
- [Acute heart failure-management during the first 120 min : Approach for early stabilization and decongestion].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- Effect of vasopressin and its analogues on microcirculatory perfusion: a systematic review.Intensive care medicine experimental · 2026Review
- ARISE framework: a temporal, multi-organ view of perfusion in sepsis.Internal and emergency medicine · 2026Review
- Lung-Cardiovascular Interactions and Derangements in ARDS.Comprehensive physiology · 2026Review
- A Data-Efficient Computational Framework for Reconstruction and Simulation of Microcirculatory Perfusion.Microcirculation (New York, N.Y. : 1994) · 2026Article
- Beyond macrocirculatory targets: a multimodal framework for microcirculatory and organ perfusion monitoring in sepsis.Critical care (London, England) · 2026Review
- Hypertonic sodium lactate improves microcirculation, modulates inflammation, and preserves vascular reactivity in a rat model of sepsis: in vivo and ex vivo evidence.Intensive care medicine experimental · 2026Article
- Venous dimension of shock: Integrating arterial inflow and venous back-pressure in hemodynamic assessment.World journal of critical care medicine · 2026Review
- Diffuse Correlation Spectroscopy for Noninvasive Monitoring of Peripheral Perfusion During Cardiogenic Shock and VA-ECMO Support: An Experimental Study.Shock (Augusta, Ga.) · 2026Article
- Dynamic flow-perfusion coupling assessed by hands-free radial artery Doppler ultrasound and capillary refill time in septic shock.Critical care (London, England) · 2026Article
- Converging evidence for a two-domain framework of microvascular dysfunction in sepsis.Critical care (London, England) · 2026Article
- Vasoplegia in Cardiac Surgery and Mechanical Circulatory Support: From Cardiopulmonary Bypass to Advanced Circulatory Support Devices.Journal of cardiovascular development and disease · 2026Review
238 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This article presents a personal viewpoint of the shortcoming of conventional hemodynamic resuscitation procedures in achieving organ perfusion and tissue oxygenation following conditions of shock and cardiovascular compromise, and why it is important to monitor the microcirculation in such conditions. The article emphasizes that if resuscitation procedures are based on the correction of systemic variables, there must be coherence between the macrocirculation and microcirculation if systemic hemodynamic-driven resuscitation procedures are to be effective in correcting organ perfusion and oxygenation. However, in conditions of inflammation and infection, which often accompany states of shock, vascular regulation and compensatory mechanisms needed to sustain hemodynamic coherence are lost, and the regional circulation and microcirculation remain in shock. We identify four types of microcirculatory alterations underlying the loss of hemodynamic coherence: type 1, heterogeneous microcirculatory flow; type 2, reduced capillary density induced by hemodilution and anemia; type 3, microcirculatory flow reduction caused by vasoconstriction or tamponade; and type 4, tissue edema. These microcirculatory alterations can be observed at the bedside using direct visualization of the sublingual microcirculation with hand-held vital microscopes. Each of these alterations results in oxygen delivery limitation to the tissue cells despite the presence of normalized systemic hemodynamic variables. Based on these concepts, we propose how to optimize the volume of fluid to maximize the oxygen-carrying capacity of the microcirculation to transport oxygen to the tissues.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.