Abstract
The aim of intensive care medicine is to maintain a supply of adequately oxygenated, nutrient-containing blood to metabolically active tissue to reduce the occurrence of tissue damage or death. In spite of this being of primary importance we have no direct methods of measuring blood flow at the point where it matters, the nutritional capillaries. The great advances made in monitoring over the past decade mean that the oxygenation of the blood in the arteries can be accurately measured and the cardiac output and total peripheral resistance can be determined. However these measurements of the physiological state of the large vessels and the blood in them may have little relevance to events at capillary level. It may often be the case that treatments which improve the values associated with the central circulation are actually deleterious to the circulation at the capillary level. Increased blood pressure may reflect a rise in peripheral resistance with a reduction in nutritional flow, whilst an increased cardiac output may be the result of the opening of shunt vessels with a fall in afterload but a diversion of flow away from nutritional vessels.
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Weinberg, J.R., Tooke, J.E. (1988). Imaging and Investigating the Microcirculation in Intensive Care Patients. In: Kox, W., Boultbee, J., Donaldson, R. (eds) Imaging and Labelling Techniques in the Critically I11. Current Concepts in Critical Care. Springer, London. https://doi.org/10.1007/978-1-4471-1440-6_16
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DOI: https://doi.org/10.1007/978-1-4471-1440-6_16
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