Tissue perfusion as the ultimate target of hemodynamic interventions in the perioperative period.

This point-of-view article examines the complex relationship between global hemodynamic parameters and tissue perfusion, emphasizing the limitations of using macrohemodynamic metrics as proxies for tissue-level oxygen delivery. Key topics of the paper include the physiological determinants of tissue perfusion, the influence of anesthesia on perfusion dynamics, and the role of hemodynamic interventions in optimizing perfusion. Furthermore, we explore the application of tissue perfusion monitoring in the perioperative setting, highlighting its potential to guide individualized therapies. By addressing these interconnected factors, we advocate for further research to evaluate whether adding perfusion-guided strategies to current protocols can enhance patient outcomes.