Assessment of the peripheral microcirculation in patients with and without shock: a pilot study on different methods

摘要: Microvascular dysfunction has been associated with adverse outcomes in critically ill patients, and the current concept of hemodynamic incoherence gained attention. Our objective was to perform a comprehensive analysis microcirculatory perfusion parameters investigate best variables that could discriminate patients without circulatory shock during early intensive care unit (ICU) admission. This prospective observational study comprised sample 40 adult (n = 20, each) admitted ICU within 24 h. Peripheral clinical [capillary refill time (CRT), peripheral index (PPI), skin-temperature gradient (Tskin-diff)] laboratory [arterial lactate base excess (BE)] parameters, addition near-infrared spectroscopy (NIRS)-derived were simultaneously assessed. While lactate, BE, CRT, PPI Tskin-diff did not differ significantly between groups, had lower baseline tissue oxygen saturation (StO2) [81 (76–83) % vs. 86 (76–90) %, p = 0.044], StO2min [50 (47–57) 55 (53–65)  %, p = 0.038] StO2max [87 (80–92) 93 (90–95) p = 0.017] than shock. Additionally, dynamic NIRS [recovery (r = 0.56, p = 0.010), descending slope (r = − 0.44, p = 0.05) ascending (r = − 0.54, p = 0.014)] static variable [baseline StO2 (r = − 0.24, p = 0.28)] exhibited significant correlation administered dose norepinephrine. In our assessed first twenty-four hours admission, among only NIRS-derived