{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:03:06Z","timestamp":1792047786293,"version":"4.4.0"},"reference-count":36,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T00:00:00Z","timestamp":1752451200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: In septic shock, microcirculatory dysfunction contributes to organ failure and mortality. While sidestream dark-field (SDF) imaging is the reference method for assessing microvascular perfusion, its complexity limits routine use. This study evaluates near-infrared spectroscopy (NIRS) with vascular occlusion testing (VOT) as a potential bedside tool for monitoring microcirculatory changes following fluid resuscitation. Methods: Sixty-three fluid-responsive patients with sepsis were randomized to receive either 20% albumin or crystalloid. NIRS-VOT and sublingual SDF measurements were obtained at baseline and 60 min post-resuscitation. The reoxygenation slope (ReOx) derived from NIRS was calculated and compared with clinical severity scores and SDF-derived microcirculatory parameters. Results: ReOx significantly increased from baseline to 60 min in the albumin group (p = 0.025), but not in the crystalloid group. However, between-group differences at 60 min were not statistically significant. ReOx at 60 min was inversely correlated with APACHE II score (\u03c1 = \u22120.325) and lactate (\u03c1 = \u22120.277) and showed a weak inverse trend with norepinephrine dose. AUROC for ICU survival based on ReOx was 0.616. NIRS ReOx showed weak correlations with SDF parameters, including the number of crossings (p = 0.03) and the consensus proportion of perfused vessels (CPPV; p = 0.004). Conclusions: NIRS-VOT detected microcirculatory trends after albumin administration but showed limited agreement with SDF imaging. These findings suggest that NIRS and SDF assess different physiological domains. Further studies are warranted to define the clinical utility of NIRS as a microcirculation monitoring tool (Clinicaltrials.gov: NCT05357339).<\/jats:p>","DOI":"10.3390\/jcm14144982","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T09:45:52Z","timestamp":1752572752000},"page":"4982","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Albumin Enhances Microvascular Reactivity in Sepsis: Insights from Near-Infrared Spectroscopy and Vascular Occlusion Testing"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4456-7220","authenticated-orcid":false,"given":"Rachael","family":"Cusack","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James\u2019 Hospital, D08 NHY1 Dublin, Ireland"},{"name":"School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8828-5984","authenticated-orcid":false,"given":"Alejandro","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Hospital Universitario Joan XXIII de Tarragona, Rovira & Virgili University, Centre for Biomedical Research Network Respiratory Diseases (CIBERES), 43005 Tarragona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Cantan","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James\u2019 Hospital, D08 NHY1 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orsolya","family":"Miskolci","sequence":"additional","affiliation":[{"name":"School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Connolly","sequence":"additional","affiliation":[{"name":"School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2840-3384","authenticated-orcid":false,"given":"Gabor","family":"Zilahi","sequence":"additional","affiliation":[{"name":"School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3607-6109","authenticated-orcid":false,"given":"John Davis","family":"Coakley","sequence":"additional","affiliation":[{"name":"School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5834-4063","authenticated-orcid":false,"given":"Ignacio","family":"Martin-Loeches","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St. James\u2019 Hospital, D08 NHY1 Dublin, Ireland"},{"name":"School of Medicine, Trinity College Dublin, D02 PN40 Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1186\/cc3753","article-title":"The Microcirculation Is the Motor of Sepsis","volume":"9","author":"Ince","year":"2005","journal-title":"Crit. 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