par De Backer, Daniel 
;Donadello, Katia
Référence Surgical Intensive Care Medicine, Third Edition, Springer International Publishing, page (91-97)
Publication Publié, 2016-01
;Donadello, Katia Référence Surgical Intensive Care Medicine, Third Edition, Springer International Publishing, page (91-97)
Publication Publié, 2016-01
Partie d'ouvrage collectif
| Résumé : | The main goal of hemodynamic resuscitation is to preserve and/or restore tissue oxygenation. However, tissue oxygenation in itself is seldom measured in clinical practice due to technical limitations. Indirect measurements such as venous oxygen saturation and lactate levels are more often measured, but these may fail to detect impairment in tissue perfusion. Recent advances in technologies have allowed to detect that microcirculatory alterations are frequently observed in critically ill patients, especially in sepsis. These alterations are characterized by a decrease in capillary density and impaired perfusion in some but not all capillaries, which induce perfusion and oxygenation heterogeneities. This is of particular relevance for monitoring as the device should be able to detect tissue perfusion heterogeneity or its consequences. In this chapter we will describe these alterations and discuss the different techniques that can be used to explore tissue perfusion/oxygenation at bedside. |
