A microcirculation-guided trial doomed to fail

Excerpt

We read with interest the recent study by Bruno et al. [ 1], testing the hypothesis that providing a single sublingual microcirculatory variable (percentage of perfused small vessels, sPPV) to the attending physician can reduce 30-day mortality in patients with various types of circulatory shock. Targeting hemodynamic interventions to promote oxygen transport by red blood cells in the microcirculation by diffusion and convection is in fact regarded as the next big step to improve resuscitation of patients with circulatory shock [ 2], enabled by recent technological advances that promise to finally bring real-time quantification of functional microcirculatory hemodynamic variables to the bedside [ 3]. …