Fig. 3

a Microcirculatory alterations in successfully weaned (SW) vs not successfully weaned (NSW) patients during weaning attempts with baseline flow (F₁₀₀) and 50% of the baseline flow (F₅₀). Examples are shown of microcirculation in the same sublingual area in two patients during F₁₀₀ and F₅₀. Images were taken from a 51-year-old man, there was cardiac recovery 3 days after tentamen suicidii with 900 mg of amlodipine and 1600 mg of hydrochlorothiazide in the same sublingual area during a weaning attempt on day 3, with no alterations in microcirculation (F₁₀₀, veno-arterial extracorporeal membrane oxygenation (VA-ECMO) flow 6.1 L/min; mean arterial pressure (MAP) 77 mmHg and F₅₀, VA-ECMO flow 3 L/min; MAP 74 mmHg). b Images were taken from a 26-year-old woman with stable human immunodeficiency virus infection (HIV) developed myocarditis and biventricular heart failure. After 4 weeks, there was no improvement in cardiac function. The microcirculatory images were documented during four weaning attempts without improvement. The same sublingual area was also used during the last weaning attempt, which showed obvious persisting deterioration in microcirculation (blue zones) (F₁₀₀, VA-ECMO flow 4.7 L/min; MAP 75 mmHg and F₅₀, VA-ECMO flow 2.7 L/min; MAP 67 mmHg). c Changes in total vessel density (TVD) in small vessels during non-successful (day 2, red) and successful (day 4, green) weaning attempts in patient 7. This 65-year-old man suffered from cardiogenic shock after coronary artery bypass graft (CABG) surgery