医学
微循环
重症监护医学
叙述性评论
内皮功能障碍
心脏病学
内科学
病理
作者
Max S. Kravitz,John H. Lee,Nathan I. Shapiro
出处
期刊:Current Opinion in Critical Care
[Ovid Technologies (Wolters Kluwer)]
日期:2024-09-27
卷期号:30 (6): 611-617
标识
DOI:10.1097/mcc.0000000000001219
摘要
Purpose of review This review provides an overview of the role of microcirculation in cardiac arrest and postcardiac arrest syndrome through handheld intravital microscopy and biomarkers. It highlights the importance of microcirculatory dysfunction in postcardiac arrest outcomes and explores potential therapeutic targets. Recent findings Sublingual microcirculation is impaired in the early stage of postarrest and is potentially associated with increased mortality. Recent work suggests that the proportion of perfused small vessels is predictive of mortality. Microcirculatory impairment is consistently found to be independent of macrohemodynamic parameters. Biomarkers of endothelial cell injury and endothelial glycocalyx degradation are elevated in postarrest settings and may predict mortality and clinical outcomes, warranting further studies. Recent studies of exploratory therapies targeting microcirculation have shown some promise in animal models but still require significant research. Summary Although research continues to suggest the important role that microcirculation may play in postcardiac arrest syndrome and cardiac arrest outcomes, the existing studies are still limited to draw any definitive conclusions. Further research is needed to better understand microcirculatory changes and their significance to improve cardiac arrest care and outcomes.
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