Thread by @HamidMerdji

🧵 Thread: The Future of Assessing Systemic Microcirculation in Cardiogenic Shock (CS) 🩺🫀

1/ Hey Twitterverse! Today, I want to talk about an exciting topic in cardiology & ICU: the role of evaluating systemic microcirculation in CS. 🌡️🫀 #ICU #Cardiology #Microcirculation

2/ CS is a life-threatening condition in which the heart is unable to pump enough blood to meet the body's metabolic needs.

academic.oup.com/ehjacc/article…

3/ Traditionally, assessment of the macrocirculation (e.g., BP, LVEF, CO) has been the focus, but new research suggests that assessment of the microcirculation is the next step.💡

4/ Microcirculation (e.g., capillaries and arterioles) play a crucial role in delivering oxygen and nutrients to tissues and removing waste products. Therefore, assessing microcirculation provides valuable insights into organ function. 🌟

5/ In the context of CS, studying microcirculation can help us understand the impact of inadequate tissue perfusion on organs. By directly observing blood flow and vessel integrity, we can assess the severity of the condition and guide appropriate interventions. 👁️💡

6/ There are various techniques to evaluate systemic microcirculation, including venous air plethysmography, videomicroscopy, skin laser Doppler imaging. These non-invasive methods allow real-time assessment, aiding prompt decision-making in these critical situations.⚡️🔬

7/ However, these technologies have many limitations, among them, limited availability.
Interestingly, surrogate indirect microcirculation assessment can also be done at the bedside using traditional priceless markers of peripheral tissue perfusion signs.

8/ Such as capillary refill time (CRT),

9/ or skin mottling (Thanks to Prof. Ait-Oufella 💪). These perfusion signs are strongly linked with microcirculatory blood flow alteration in cardiogenic shock.

10/ Research has shown that assessing microcirculation in CS provides prognostic information beyond traditional macrocirculatory parameters. These microcirculatory parameters perform even better than those of the macrocirculation in predicting outcomes‼️

11/ By identifying impaired microcirculation early on, we can tailor treatment strategies to address the specific needs of each patient. 📈🔍

12/ In conclusion, as we delve deeper into the understanding of CS, evaluating systemic microcirculation emerges as a crucial aspect of comprehensive patient care. It holds tremendous potential to guide treatment decisions, improve outcomes, and save lives. 🌠💙

13/ Let's keep pushing the boundaries of knowledge and champion the integration of microcirculatory assessment into routine clinical practice. Let's keep pushing the boundaries of knowledge and champion the integration of microcirculatory assessment into routine clinical practice

14/ If you want to know more, do not hesitate to read our recent review (with world-renowned experts) about "Microcirculatory dysfunction in cardiogenic shock". It is open access in @of_aic

annalsofintensivecare.springeropen.com/articles/10.11…

15/ And find out if the microcirculation can be improved during cardiogenic shock?

#CardiogenicShock #Microcirculation #ICU #Cardiology #MedicalAdvancements