Microvascular Fluid Resuscitation in Circulatory Shock

The microcirculation is responsible for blood flow regulation and red blood cell distribution throughout individual organs. Patients with circulatory shock have acute failure of the cardiovascular system in which there is insufficient delivery of oxygen to meet metabolic tissue requirements. All subtypes of shock pathophysiology have a hypovolemic component. Fluid resuscitation guided by systemic hemodynamic end points is a common intervention. Evidence shows that microcirculatory shock persists even after optimization of macrocirculatory hemodynamics. The ability for nurses to assess the microcirculation at the bedside in real-time during fluid resuscitation could lead to improved algorithms designed to resuscitate the microcirculation.