Figure 1.

Microcirculatory alterations associated with loss of hemodynamic coherence. Microcirculatory alterations underlying the loss of hemodynamic coherence between the macrocirculation and the microcirculation resulting in tissue hypoxiaType 1: heterogeneous perfusion of the microcirculation as seen in septic patients with obstructed capillaries next to perfused capillaries resulting in a heterogeneous oxygenation of the tissue cells. Type 2: hemodilution with the dilution of microcirculatory blood resulting in the loss of RBC-filled capillaries and increasing diffusion distance between RBCs in the capillaries and the tissue cells. Type 3: stasis of microcirculatory RBC flow induced by alterd systemic variables (e.g. increased arterial vascular resistance(R) and or increased venous pressures causing tamponade 4 alterations involve edema caused by capillary leak syndrome and which results in increased diffusive distance and reduced ability of the oxygen to reach the tissue cells. Red, well-oxygenated RBC and tissue cells; purple, RBC with reduced oxygenation; blue, reduced tissue cell oxygenation