Microcirculatory Monitoring to Assess Cardiopulmonary Status

The main purpose of monitoring the microcirculation is to provide insights to help better understanding the physiology and disease states in a personalized and physiological approach. Various techniques exist for microcirculatory monitoring, and contemporary technologic advances have made available bedside use of these techniques, especially in Critically III patients. Currently, handheld vital microscopes, laser-based techniques, and near-infrared spectroscopy are mostly used, as well as well-known microcirculatory monitoring techniques. Each of these techniques is used for assessing different phases of tissue oxygenation such as convection, diffusion, and oxygen utilization. Handheld vital microscopes provide information regarding oxygen diffusion and convection and are adopted as the gold standard since they enable quantitative output by direct visualization of the microcirculation. Laser-based techniques and near-infrared spectroscopy provide information on convection and oxygen delivery/utilization, respectively. Each technique has its limitation and advantages to be preferred or denied. In this chapter, we will discuss the most commonly used microcirculatory monitoring techniques with their fundamental principles, strengths, and weaknesses.