The Principle of Tissue Perfusion and Microcirculation Monitoring Technology and Its Application in the Management of Critically Ill Patients

Mengmeng Wen

doi:10.62051/ijphmr.v6n1.07

Authors

Mengmeng Wen

DOI:

https://doi.org/10.62051/ijphmr.v6n1.07

Keywords:

Tissue perfusion, Microcirculation monitoring, Management of critically ill patients, Hemodynamics, Clinical application

Abstract

Insufficient tissue perfusion and microcirculation disorders are the core pathological mechanisms of multiple organ dysfunction in critically ill patients. Timely and accurate monitoring is a key link in improving prognosis and reducing the incidence of multiple organ failure. This article systematically elaborates on the physiological basis of tissue perfusion and microcirculation, summarizes the precision advantages of invasive monitoring and the convenience characteristics of non-invasive monitoring, clarifies the core principles of different technologies and their adaptation scenarios in different subtypes of severe diseases such as sepsis and hemorrhagic shock, deeply analyzes their core values in early disease identification, severity grading, treatment plan adjustment, and prognosis risk warning, and combines authoritative clinical data to support the monitoring technology's role in diagnosis and treatment decision-making. Finally, it explores the operational limitations, equipment popularization difficulties, and future development directions in the application of technology. The multicenter studies included in the "Chinese Guidelines for Critical Care Medicine (2023 Edition)" show that the scientific application of monitoring technology can increase the treatment compliance rate of critically ill patients by 32.6%, reduce mortality rates by 16.8%–19.3%, and provide important support for the implementation of precision and personalized diagnosis and treatment in critical care medicine.

References

[1] Sakr Y, Dubois M J, De Backer D, et al. Persistent microcirculatory alterations are associated with organ failure and death in patients with septic shock [J]. Critical care medicine, 2004, 32(9): 1825-1831.

[2] Guven G, Hilty M P, Ince C. Microcirculation: physiology, pathophysiology, and clinical application [J]. Blood purification, 2020, 49(1-2): 143-150.

[3] De Backer D, Ospina-Tascon G, Salgado D, et al. Monitoring the microcirculation in the critically ill patient: current methods and future approaches [J]. Intensive care medicine, 2010, 36(11): 1813-1825.

[4] Evans L, Rhodes A, Alhazzani W, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021 [J]. Critical care medicine, 2021, 49(11): e1063-e1143.

[5] Mari A, Nougue H, Mateo J, et al. Transcutaneous PCO2 monitoring in critically ill patients: update and perspectives [J]. Journal of thoracic disease, 2019, 11(Suppl 11): S1558.

[6] Jung C, Kelm M. Evaluation of the microcirculation in critically ill patients [J]. Clinical Hemorheology and Microcirculation, 2015, 61(2): 213-224.

[7] De Backer D, Creteur J, Preiser J C, et al. Microvascular blood flow is altered in patients with sepsis [J]. American journal of respiratory and critical care medicine, 2002, 166(1): 98-104.

[8] Bruno R R, Wollborn J, Fengler K, et al. Direct assessment of microcirculation in shock: a randomized-controlled multicenter study [J]. Intensive Care Medicine, 2023, 49(6): 645-655.

[9] Joosten A, Desebbe O, Suehiro K, et al. Accuracy and precision of non-invasive cardiac output monitoring devices in perioperative medicine: a systematic review and meta-analysis [J]. BJA: British Journal of Anaesthesia, 2017, 118(3): 298-310.

[10] Heidt B, Siqueira W F, Eersels K, et al. Point of care diagnostics in resource-limited settings: A review of the present and future of PoC in its most needed environment [J]. Biosensors, 2020, 10(10): 133.