Resuscitation incoherence and dynamic circulation-perfusion coupling in circulatory shock / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 1218-1227, 2019.
Article
em En
| WPRIM
| ID: wpr-772213
Biblioteca responsável:
WPRO
ABSTRACT
OBJECTIVE@#Poor tissue perfusion/cellular hypoxia may persist despite restoration of the macrocirculation (Macro). This article reviewed the literatures of coherence between hemodynamics and tissue perfusion in circulatory shock.@*DATA SOURCES@#We retrieved information from the PubMed database up to January 2018 using various search terms or/and their combinations, including resuscitation, circulatory shock, septic shock, tissue perfusion, hemodynamic coherence, and microcirculation (Micro).@*STUDY SELECTION@#The data from peer-reviewed journals printed in English on the relationships of tissue perfusion, shock, and resuscitation were included.@*RESULTS@#A binary (coherence/incoherence, coupled/uncoupled, or associated/disassociated) mode is used to describe resuscitation coherence. The phenomenon of resuscitation incoherence (RI) has gained great attention. However, the RI concept requires a more practical, systematic, and comprehensive framework for use in clinical practice. Moreover, we introduce a conceptual framework of RI to evaluate the interrelationship of the Macro, Micro, and cell. The RI is divided into four types (Type 1 Macro-Micro incoherence + impaired cell; Type 2 Macro-Micro incoherence + normal cell; Type 3 Micro-Cell incoherence + normal Micro; and Type 4 both Macro-Micro and Micro-cell incoherence). Furthermore, we propose the concept of dynamic circulation-perfusion coupling to evaluate the relationship of circulation and tissue perfusion during circulatory shock.@*CONCLUSIONS@#The concept of RI and dynamic circulation-perfusion coupling should be considered in the management of circulatory shock. Moreover, these concepts require further studies in clinical practice.
Texto completo:
1
Índice:
WPRIM
Idioma:
En
Revista:
Chinese Medical Journal
Ano de publicação:
2019
Tipo de documento:
Article