{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T18:14:02Z","timestamp":1773425642557,"version":"3.50.1"},"reference-count":97,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T00:00:00Z","timestamp":1772928000000},"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>Sepsis and septic shock remain major causes of morbidity and mortality in critically ill patients. Hemodynamic management is a cornerstone of treatment, yet the optimal monitoring strategy to guide resuscitation is still debated. The progressive decline in the use of invasive techniques, such as pulmonary artery catheterization, has favored the development of less-invasive and non-invasive monitoring approaches. Recent technologies allow continuous assessment of cardiovascular function through arterial waveform analysis, non-invasive blood pressure monitoring, and predictive algorithms, while increasing attention has been directed toward the evaluation of tissue perfusion and oxygenation. This reflects the recognition that normalization of macrocirculatory variables does not necessarily ensure adequate microcirculatory perfusion in sepsis. This narrative review summarizes current evidence on less-invasive hemodynamic and tissue perfusion monitoring in sepsis and septic shock, discussing their physiological rationale and potential role within contemporary, multimodal resuscitation strategies.<\/jats:p>","DOI":"10.3390\/jcm15052061","type":"journal-article","created":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T08:58:45Z","timestamp":1773046725000},"page":"2061","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Less-Invasive Hemodynamic and Tissue Perfusion Monitoring in Sepsis and Septic Shock: A Narrative Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2470-7057","authenticated-orcid":false,"given":"Marialaura","family":"Scarcella","sequence":"first","affiliation":[{"name":"Anesthesia and Intensive care Department, Perugia University, 06121 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8081-7480","authenticated-orcid":false,"given":"Paolo","family":"Formenti","sequence":"additional","affiliation":[{"name":"Critical Care and Anesthesiology Department, Ospedale Bassini, ASST Nord Milano, Cinisello Balsamo, 20095 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Marco","family":"Petroni","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive care Unit, Azienda ospedaliera Santa Maria of Terni, 05100 Terni, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Monti","sequence":"additional","affiliation":[{"name":"Anhestesiology and Operating Room Department, Azienda ospedaliera Santa Maria di Terni, 05100 Terni, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"De Robertis","sequence":"additional","affiliation":[{"name":"Anesthesia and Intensive care Department, Perugia University, 06121 Perugia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"801","DOI":"10.1001\/jama.2016.0287","article-title":"The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)","volume":"315","author":"Singer","year":"2016","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/S0140-6736(19)32989-7","article-title":"Global, Regional, and National Sepsis Incidence and Mortality, 1990\u20132017: Analysis for the Global Burden of Disease Study","volume":"395","author":"Rudd","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Valeanu, L., Bubenek-Turconi, S.-I., Ginghina, C., and Balan, C. 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