Could resuscitation be based on microcirculation data? Yes

Dear Editor,
What is microcirculatory shock? The concept of shock has been central in the ideas governing resuscitation. From a clinical macrocirculatory point of view, Weil and Henning described the four states of shock as including cardiogenic, obstructive, distributive, and hypovolemic shock. Shock is defined as a condition whereby the circulation is unable to deliver adequate blood flow to meet the metabolic demands of the parenchymal cells needed to support organ function and/or when cellular metabolism dysfunction occurs. In the description of clinical shock the conceptual origin of shock has been emphasized as being of a cellular nature. From this latest perspective, shock concerns a cellular definition. The physiological interface compartment between macrocirculatory shock and cellular shock is therefore open to discussion and definition, i.e., the microcirculation. [...]