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Objective: To explore the progress of microcirculation research in shock and sepsis from 2000 to 2019 based on knowledge visualization analysis., Methods: The literatures related to microcirculation of shock and sepsis published in Web of Science and Wanfang databases were collected from 2000 to 2019. Then, data collected was sorted out and used to make bar charts and curves reflecting the growth trend of the literatures using Excel software. The information about country, institution and author were extracted by CiteSpace 5.0 R1 for generating co-occurring network, to find the main research power and each cooperative relation. This software was also used to analyze the related-keywords and cited reference, so that the map of co-citation reference was drawn subsequently to explore the frontiers and hot spots in this field., Results: There were a total of 2 000 Chinese "papers" or "dissertations", 1 823 English "articles" or "reviews", collected preliminarily. The Chinese literatures were only statistically described for the amounts, institutions and authors, however, all retrieved English literatures were enrolled in the visualization analysis eventually. From 2009 to 2019, the number of English literatures rose steadily; however, the number of Chinese literatures had been sliding since 2011. On terms of quality, the impact factors of most literatures were under 6, lacking high quality ones, and the number remained stable every year. According to the analysis of English literatures, the top three countries that published related papers around the world were Germany (n = 430), the United States (n = 401) and Netherlands (n = 223). In the aspect of research institutions, the University of Amsterdam (Netherlands) ranked first in the Web of Science (n = 113), while the institution in China with the most publications was the Southern Medical University (n = 71). According to the analysis of co-occurring author network, there were three major globe scientific groups in which Can Ince, Daniel De Backer and Jean-Louis Vincent contributed most to this research field. The top three authors who published most Chinese papers were Niu Chunyu (n = 20), Zhao Zigang (n = 18) and Duan Meili (n = 13). By generating the co-occurring keyword mapping, the research hot spots mainly focused on "blood flow", "nitric oxide", "hemorrhagic shock" and "perfusion". However, these burst keywords, including "cardiogenic shock", "acute kidney injury", "fluid resuscitation", "sublingual microcirculation", "mortality", "oxidative stress", and "critically ill patient", represented the frontiers in microcirculation research of shock and sepsis field. Finally, the results of co-citation reference analysis showed that "sublingual microcirculation" and "mottling score" were most active, indicating that the research of microcirculation monitoring technology could be considered as a hot spot and also the frontier in this field, which was consistent with the results of co-occurring keywords network., Conclusions: Knowledge visualization analysis can visually exhibit the hot spot and trend of microcirculation research in shock and sepsis. The power was mainly focused on a few developed countries in Europe, and the trend was more inclined to the related microcirculation monitoring technology.

Objective: The European Society of Intensive Care Medicine (ESICM) issued the second consensus on the assessment of sublingual microcirculation in critically ill patients. This paper interprets the consensus for clinicians about: what is microcirculation, how to observe microcirculation, and the details of microcirculation images collection and parameters analysis. Besides, this paper illustrates the relationship between microcirculation alternation and shock, it also evaluates the present situation and future development of microcirculation monitoring.