'Death and life are in the power of the tongue'?

摘要

Cardiogenic shock (CS) remains one of the most serious cardiovascular emergencies with an early mortality of about 50% despite application of early coronary intervention and utmost modern mechanical and pharmaceutical support in intensive care units [1]. In an elegant work Corstiaan et al. [2] reported a potential dissociation between enhanced macrovascular hemodynamics and sublingual microcirculation during intra-aortic counterpulsation (IACP). The authors have shown that reducing IACP assist ratios from 1:1 to 1:8 for 15 minutes does not substantially impair sublingual mi-crocirculatory perfusion (measured by perfused capillary flow density and capillary red blood cell velocity) in patients with CS. What is the relevance of these findings?