Abstract
Microcirculatory dysfunction plays a central role in sepsis pathophysiology and is associated with poor clinical outcomes. While advances in bedside tools and biomarkers offer potential for identifying microcirculatory dysfunction, most therapies targeting the microcirculation have not translated into improved clinical outcomes. Future advances likely lie in precision medicine approaches that employ microcirculatory measurements to guide individualized resuscitation strategies. This article highlights current evidence on the physiology, assessment, and therapeutic approaches to microvascular dysfunction in sepsis, underscoring the need for precision medicine strategies and further research into patient subgroups that may benefit from microcirculation directed interventions.