Macro–Micro Circulatory State and Trajectory Tool (Demo)
Interactive trajectory interpretation based on serial VTI and PI measurements
Background
Macrocirculatory flow and microcirculatory perfusion are related but not interchangeable.
In this framework, left ventricular outflow tract velocity–time integral (VTI) is used as a
surrogate of global flow, whereas perfusion index (PI) reflects peripheral perfusion.
Their contemporaneous combination defines four macro–micro circulatory states. Serial
state transitions are then summarized into a trajectory phenotype.
State Definitions
Concordant high-flow: VTI ≥ 16.9 and PI ≥ 1.2
Macro-predominant mismatch: VTI < 16.9 and PI ≥ 1.2
Micro-predominant mismatch: VTI ≥ 16.9 and PI < 1.2
Concordant low-flow: VTI < 16.9 and PI < 1.2
Input
Default labels are Day 1, Day 2, and Day 3. You may edit the time labels, add additional
time points, or remove rows as needed.
Time
VTI (cm)
PI
State
Action
Trajectory logic:
Favorable trajectory requires persistent concordant high-flow without concordant low-flow.
Improving trajectory reflects an overall shift toward lower severity.
Worsening trajectory reflects an overall shift toward higher severity or persistent concordant low-flow.
Fluctuating trajectory is assigned when bidirectional switching prevents a sustained directional interpretation.
Results
Time-point state classification
No analysis yet.
Trajectory phenotype
Awaiting input
Framework-based risk tier
Awaiting input
Trajectory features
Baseline: —
Final: —
Reversal: —
Interpretation
Enter serial VTI and PI values and click “Analyze Pattern”.
This tool is intended for research, educational, and hypothesis-generating purposes only.
It is not designed for clinical decision-making or patient management.
Data Privacy
No input data are stored, transmitted, or shared. All calculations are performed locally
in the user's browser.
Methodological Note
State classification is based on predefined VTI and PI cutoffs. Trajectory classification
is determined by overall direction, dominant severity pattern, and the presence or absence
of bidirectional reversals.
Suggested Citation
Wang J, et al. A Time-Dependent Macro–Micro Circulatory Framework for Prognosis in Critical Illness. (in preparation)