INTRAVENOUS FLUIDS: Edited by Bertrand GuidetMicrocirculatory disorders during septic shockAit-Oufella, Hafida,b,c; Bourcier, Simona,b; Lehoux, Sophiec; Guidet, Bertranda,d,eAuthor Information aAP-HP, Hôpital Saint-Antoine, Service de réanimation médicale, Paris bUniversité Pierre et Marie Curie cInserm U970, Centre de recherche cardiovasculaire de Paris (PARCC), Paris, France dLady Davis Institute, McGill University, Montréal, Canada eInserm U1136, Paris, France Correspondence to Professor Hafid Ait-Oufella, Service de réanimation médicale, Hôpital Saint-Antoine, 184 rue du Faubourg Saint-Antoine, 75571 Paris, cedex 12, France. E-mail: [email protected] Current Opinion in Critical Care: August 2015 - Volume 21 - Issue 4 - p 271-275 doi: 10.1097/MCC.0000000000000217 Buy Metrics Abstract Purpose of review Despite the progress made over the past 20 years in the treatment of septic shock, mortality remains high. Microcirculatory disorders raise considerable interest aiming to improve the understanding of the physiopathology of septic shock and its management. Recent findings Numerous experimental and clinical studies have gradually focused on the analysis of microcirculatory blood flow and identified alterations in small vessels. These microcirculatory abnormalities appear early, are heterogeneous, and are directly linked to organ failure, as well as the patient's prognosis. These anomalies vary from one patient to the other, and their evolution during resuscitation cannot be predicted by the isolated analysis of global hemodynamic parameters such as blood pressure or heart rate. Summary Microcirculatory disorders appear at a central place of the physiopathology and are highly associated with the patient prognosis; it therefore seems important to develop and integrate parameters reflecting tissue perfusion in the management of septic shock. Copyright © 2015 YEAR Wolters Kluwer Health, Inc. All rights reserved.