Early peripheral perfusion monitoring in septic shock

Septic shock is a frequent critical clinical condition and a leading cause of death in critically ill individuals. However, it is challenging to identify affected patients early. In this article, we discuss new perspectives on the methods and uses of peripheral perfusion monitoring, considering the concept of a dysregulated response. Physical examination, and visual and ultrasonographic techniques are used to measure peripheral microcirculatory blood flow to reflect tissue perfusion. Compared with other monitoring techniques, peripheral perfusion monitoring has the benefits of low invasiveness and good repeatability, and allows for quick therapeutic judgments, which have significant practical relevance. Peripheral perfusion monitoring is an effective tool to detect early signs of septic shock, autonomic dysfunction, and organ damage. This method can also be used to evaluate treatment effectiveness, direct fluid resuscitation and the use of vasoactive medications, and monitor vascular reactivity, microcirculatory disorders, and endothelial cell damage. Recent introductions of novel peripheral perfusion monitoring methods, new knowledge of peripheral perfusion kinetics, and multimodal peripheral perfusion evaluation methods have occurred. To investigate new knowledge and therapeutic implications, we examined the methodological attributes and mechanisms of peripheral perfusion monitoring, in this study. Peripheral perfusion monitoring enables early detection of alterations in microcirculation, which can indicate changes in tissue perfusion.Peripheral perfusion kinetics indicate that peripheral perfusion parameters undergo regular dynamic changes that can be used to track the effects of therapeutic interventions and monitor disease progression.Peripheral perfusion monitoring can assess autonomic function and serve as the foundation for appropriate treatment.New technologies for measuring peripheral perfusion, such as laser and ultrasound technology, are being developed.Further investigation into peripheral perfusion monitoring is warranted due to our improved understanding of the underlying mechanisms and its potential to optimize perfusion and systemic hemodynamic variables in the management of septic shock.Peripheral perfusion may have a wider clinical role thanks to multimodal assessment.