A new generation computer-controlled imaging sensor-based hand-held microscope for quantifying bedside microcirculatory alterations.

The microcirculation is the final station for oxygen transport to the tissues and plays a key role in the cardiovascular system. The microcirculation includes all the vessels that are smaller than 100 micrometer in diameter and has a crucial role in blood and tissue interactions in physiological and pathophysiological states. Many studies have demonstrated that persistent microcirculatory alterations that are unresponsive to therapy are independently associated with adverse outcome, especially in septic patients (e. g.,). Additionally, these microcirculatory alterations are independent of systemic hemodynamic variables; therefore, microcirculatory observations are a potentially important extension of conventional systemic hemodynamic monitoring of critically ill patients. These findings have been made possible by introduction of hand-held microscopes to surgery and intensive care and in this chapter we present the latest generation of these hand-held devices.