It is therefore important to develop accurate parameters at the bedside to evaluate tissue perfusion.
As microcirculatory disorders have been identified as strong predictive factors of unfavourable outcome, there is a need to develop accurate parameters at the bedside to evaluate tissue perfusion.
As microcirculatory disorders have been identified as strong predictive factors of unfavourable outcome, there is a need to develop accurate parameters at the bedside to evaluate tissue perfusion [8].
T1-weighted DCE-MRI techniques are able to evaluate tissue perfusion and vascular leakage based on signal changes secondary to the presence of low-molecular-weight contrast media in the EES [6, 7, 8, 31] (Fig. 4).
Since ∆PCO2 is now widely recognized as a valuable marker to evaluate tissue perfusion in septic shock, a clinician should be aware that acute changes in pH or PaCO2 induced by hyperventilation could impact ∆PCO2 independently of changes in tissue perfusion.
Once end-points are met it is important to re-evaluate tissue perfusion continuously to determine the need for further volume expansion.
The new imaging tools able to evaluate tissue perfusion (both by CT or MRI) and cellularity (Diffusion Weighted MRI) can be applied to evaluate vascular damage prior the ischemic changes and especially in differential diagnosis of fibrosis versus recurrent tumor.
Perfusion CT can measure tissue perfusion parameters quantitatively and can assess segmental hepatic function.
However, dynamic monitoring does not measure tissue perfusion.
Recently, some studies have been done to explore the value of evaluating peripheral tissue perfusion of other sites in septic shock patients, such as thenar, deltoid, masseter, and ear sites [ 40, 41].
