{"id":15436,"date":"2026-03-24T11:26:50","date_gmt":"2026-03-24T10:26:50","guid":{"rendered":"https:\/\/www.soccorritori.ch\/?p=15436"},"modified":"2026-03-24T11:27:47","modified_gmt":"2026-03-24T10:27:47","slug":"marezzature-della-pelle-livedo-reticularis","status":"publish","type":"post","link":"https:\/\/www.soccorritori.ch\/?p=15436","title":{"rendered":"Marezzature della pelle (Livedo reticularis)"},"content":{"rendered":"<p><strong>Rilevanza clinica per il soccorritore<\/strong><\/p>\n<h2>Introduzione (caso clinico)<\/h2>\n<p>Equipaggio inviato per <strong>malessere generale<\/strong> in paziente anziano.<br \/>\nAll\u2019arrivo: PA 90\/60 mmHg, FC 118 bpm, cute <strong>fredda e marezzata<\/strong>, refill capillare &gt; 4 s. SpO\u2082 93%.<\/p>\n<p>Segno suggestivo di <strong>ipoperfusione periferica<\/strong> e possibile <strong>shock<\/strong>.<\/p>\n<hr>\n<h2>Definizione<\/h2>\n<p>Pattern cutaneo reticolare violaceo dovuto ad alterazione del microcircolo.<\/p>\n<hr>\n<h2>Fisiopatologia<\/h2>\n<ul>\n<li>Vasocostrizione arteriolare<\/li>\n<li>Riduzione della perfusione capillare<\/li>\n<li>Stasi venulare<\/li>\n<li>Distribuzione reticolare del flusso<\/li>\n<\/ul>\n<p>Nei quadri di shock indica <strong>perfusione periferica compromessa<\/strong>.<\/p>\n<hr>\n<h2>Significato clinico<\/h2>\n<ul>\n<li>Fisiologico (freddo)<\/li>\n<li>Segno di ipoperfusione<\/li>\n<li>Possibile shock (ipovolemico, settico, cardiogeno)<\/li>\n<\/ul>\n<p><strong>Attenzione:<\/strong> marezzature persistenti associate a cute fredda indicano possibile instabilit\u00e0 emodinamica.<\/p>\n<hr>\n<h2>Mottling Score<\/h2>\n<ul>\n<li><strong>0<\/strong> = assente<\/li>\n<li><strong>1<\/strong> = ginocchio<\/li>\n<li><strong>2<\/strong> = sopra ginocchio<\/li>\n<li><strong>3<\/strong> = met\u00e0 coscia<\/li>\n<li><strong>4<\/strong> = inguine<\/li>\n<li><strong>5<\/strong> = tronco<\/li>\n<\/ul>\n<p>Score \u22652 suggerisce ipoperfusione significativa.<br \/>\nValutare sempre il <strong>trend<\/strong>.<\/p>\n<hr>\n<h2>Valutazione (ABCDE)<\/h2>\n<h3>Circulation<\/h3>\n<ul>\n<li>Pressione arteriosa<\/li>\n<li>Frequenza cardiaca<\/li>\n<li>Refill capillare (&gt;2 s patologico)<\/li>\n<li>Temperatura cutanea<\/li>\n<li>Estensione marezzature<\/li>\n<\/ul>\n<hr>\n<h2>Red flags<\/h2>\n<ul>\n<li>Marezzature diffuse e persistenti<\/li>\n<li>Ipotensione<\/li>\n<li>Tachicardia<\/li>\n<li>Alterazione dello stato mentale<\/li>\n<li>Segni di sepsi o emorragia<\/li>\n<\/ul>\n<hr>\n<h2>Gestione<\/h2>\n<ul>\n<li>Ossigeno<\/li>\n<li>Accesso venoso<\/li>\n<li>Fluidoterapia con rivalutazione<\/li>\n<li>Monitoraggio continuo<\/li>\n<li>Trasporto rapido con preallerta<\/li>\n<\/ul>\n<p><strong>Nota:<\/strong> rivalutare frequentemente; il trend \u00e8 pi\u00f9 importante del singolo dato.<\/p>\n<hr>\n<h2>Segni di peggioramento<\/h2>\n<ul>\n<li>Aumento refill capillare<\/li>\n<li>Estensione marezzature<\/li>\n<li>Calo pressione arteriosa<\/li>\n<li>Peggioramento neurologico<\/li>\n<\/ul>\n<hr>\n<h2>Riferimenti<\/h2>\n<ul>\n<li>European Resuscitation Council (ERC)<\/li>\n<li>Surviving Sepsis Campaign<\/li>\n<li>Manuali di emergenza preospedaliera<\/li>\n<\/ul>\n<hr>\n<h2>Conclusione<\/h2>\n<p>Le marezzature cutanee sono un segnale precoce di ipoperfusione e devono essere riconosciute rapidamente nel contesto clinico.<\/p>\n<p><strong>1. Marezzature cutanee (livedo reticularis)<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\">\n<tbody>\n<tr>\n<td style=\"width: 25%;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-15450 aligncenter\" src=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/gr1_lrg-1024x812.jpg\" alt=\"\" width=\"1024\" height=\"812\" srcset=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/gr1_lrg-1024x812.jpg 1024w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/gr1_lrg-150x119.jpg 150w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/gr1_lrg-768x609.jpg 768w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/gr1_lrg-1536x1218.jpg 1536w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/gr1_lrg.jpg 1777w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/td>\n<td style=\"width: 25%;\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-15451 aligncenter\" src=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/Livedo_reticularis_of_an_arm.png\" alt=\"\" width=\"300\" height=\"444\" srcset=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/Livedo_reticularis_of_an_arm.png 512w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/Livedo_reticularis_of_an_arm-101x150.png 101w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><\/td>\n<td style=\"width: 25%;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15452 aligncenter\" src=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/Livedo_reticularis_of_left_leg.jpg\" alt=\"\" width=\"600\" height=\"292\" srcset=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/Livedo_reticularis_of_left_leg.jpg 600w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/Livedo_reticularis_of_left_leg-150x73.jpg 150w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><\/td>\n<td style=\"width: 25%;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15453 aligncenter\" src=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/an01622_im00862_ans7_livedo_reticularisthu_jpg.webp\" alt=\"\" width=\"632\" height=\"456\" srcset=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/an01622_im00862_ans7_livedo_reticularisthu_jpg.webp 632w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/an01622_im00862_ans7_livedo_reticularisthu_jpg-150x108.webp 150w\" sizes=\"auto, (max-width: 632px) 100vw, 632px\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><strong>2. Cute marezzata in ipoperfusione (shock\/sepsi)<\/strong><\/p>\n<table style=\"border-collapse: collapse; width: 100%;\">\n<tbody>\n<tr>\n<td style=\"width: 25%;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15455 aligncenter\" src=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/yN0xVoYuJh4BEkqfFoUqx7NzodJ6fFdHpJ3uKbHyMvDZ0MOpjEPdeteWevSF_89D-g4v9X5lEPwgF5Xn0lGefiSJ6Qf31XWoBysxNrGfS9DF0tT9QlRjmQLTe52YrTK7oIgYaM7KXUQi26y4qK0UXg.jpeg\" alt=\"\" width=\"225\" height=\"225\" srcset=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/yN0xVoYuJh4BEkqfFoUqx7NzodJ6fFdHpJ3uKbHyMvDZ0MOpjEPdeteWevSF_89D-g4v9X5lEPwgF5Xn0lGefiSJ6Qf31XWoBysxNrGfS9DF0tT9QlRjmQLTe52YrTK7oIgYaM7KXUQi26y4qK0UXg.jpeg 225w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/yN0xVoYuJh4BEkqfFoUqx7NzodJ6fFdHpJ3uKbHyMvDZ0MOpjEPdeteWevSF_89D-g4v9X5lEPwgF5Xn0lGefiSJ6Qf31XWoBysxNrGfS9DF0tT9QlRjmQLTe52YrTK7oIgYaM7KXUQi26y4qK0UXg-150x150.jpeg 150w\" sizes=\"auto, (max-width: 225px) 100vw, 225px\" \/><\/td>\n<td style=\"width: 25%;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-15456 aligncenter\" src=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/nejmicm1602055_f1-1024x788.jpg\" alt=\"\" width=\"1024\" height=\"788\" srcset=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/nejmicm1602055_f1-1024x788.jpg 1024w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/nejmicm1602055_f1-150x115.jpg 150w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/nejmicm1602055_f1-768x591.jpg 768w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/nejmicm1602055_f1-1536x1182.jpg 1536w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/nejmicm1602055_f1-2048x1576.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/td>\n<td style=\"width: 25%;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15457 aligncenter\" src=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/2zvxPd0XkWmzJwNaoSdYjwjIwfFiyrrABHmDIquILhD-3W6gFMktRkfXAn6rf3zxIngtqIIzFSHfBZJq6_TAywtABbGO-XgdVDD5o_Ivb-0R_NcVXYpACW7oRJEEv68PjRWlVg4y2j4jc3Utd3sLXg.jpeg\" alt=\"\" width=\"282\" height=\"179\" srcset=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/2zvxPd0XkWmzJwNaoSdYjwjIwfFiyrrABHmDIquILhD-3W6gFMktRkfXAn6rf3zxIngtqIIzFSHfBZJq6_TAywtABbGO-XgdVDD5o_Ivb-0R_NcVXYpACW7oRJEEv68PjRWlVg4y2j4jc3Utd3sLXg.jpeg 282w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/2zvxPd0XkWmzJwNaoSdYjwjIwfFiyrrABHmDIquILhD-3W6gFMktRkfXAn6rf3zxIngtqIIzFSHfBZJq6_TAywtABbGO-XgdVDD5o_Ivb-0R_NcVXYpACW7oRJEEv68PjRWlVg4y2j4jc3Utd3sLXg-150x95.jpeg 150w\" sizes=\"auto, (max-width: 282px) 100vw, 282px\" \/><\/td>\n<td style=\"width: 25%;\"><img loading=\"lazy\" decoding=\"async\" class=\"size-full wp-image-15458 aligncenter\" src=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/mottling-score-surviving-septic-shock-image-1.png\" alt=\"\" width=\"740\" height=\"676\" srcset=\"https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/mottling-score-surviving-septic-shock-image-1.png 740w, https:\/\/www.soccorritori.ch\/wp-content\/uploads\/2026\/03\/mottling-score-surviving-septic-shock-image-1-150x137.png 150w\" sizes=\"auto, (max-width: 740px) 100vw, 740px\" \/><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>&nbsp;<\/p>\n<table style=\"width: 100%;\" border=\"0\">\n<tbody>\n<tr>\n<td>Fonti:<\/p>\n<ul>\n<li><strong>European Resuscitation Council (ERC)<\/strong> \u2013 Linee guida per la gestione dello shock e della rianimazione (2021)<\/li>\n<li><strong>Surviving Sepsis Campaign<\/strong> \u2013 International Guidelines for Management of Sepsis and Septic Shock (2021)<\/li>\n<li>Ait-Oufella H, Lemoinne S, Boelle PY, et al.<br \/>\n<em>Mottling score predicts survival in septic shock.<\/em> Intensive Care Medicine, 2011<\/li>\n<li>Hernandez G, Ospina-Tasc\u00f3n GA, Damiani LP, et al.<br \/>\n<em>Effect of a resuscitation strategy targeting peripheral perfusion status vs serum lactate levels.<\/em> JAMA, 2019<\/li>\n<li>Vincent JL, De Backer D.<br \/>\n<em>Microvascular dysfunction as a cause of organ failure in severe sepsis.<\/em> Critical Care, 2005<\/li>\n<li>Marino PL.<br \/>\n<em>The ICU Book.<\/em> 4th Edition \u2013 capitoli su shock e perfusione periferica<\/li>\n<li>Tintinalli JE.<br \/>\n<em>Emergency Medicine: A Comprehensive Study Guide.<\/em> \u2013 sezioni su shock e valutazione clinica<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"text-align: justify;\">\n<address><span style=\"font-size: xx-small;\"><strong>Le foto presenti sul sito sono state in larga parte reperite su Internet e quindi valutate di pubblico dominio. Se i soggetti o gli autori avessero qualcosa in contrario alla pubblicazione, non avranno che da segnalarlo all\u2019indirizzo e-mail <a href=\"mailto:admin@soccorritori.ch\">admin@soccorritori.ch<\/a>, lo Staff provveder\u00e0 prontamente alla rimozione delle immagini utilizzate.<\/strong><\/span><\/address>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n","protected":false},"excerpt":{"rendered":"<p>Rilevanza clinica per il soccorritore Introduzione (caso clinico) Equipaggio inviato per malessere generale in paziente anziano. All\u2019arrivo: PA<\/p>\n","protected":false},"author":1153,"featured_media":15458,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"ngg_post_thumbnail":0,"cybocfi_hide_featured_image":"","footnotes":"","_wpscppro_dont_share_socialmedia":false,"_wpscppro_custom_social_share_image":0,"_facebook_share_type":"","_twitter_share_type":"","_linkedin_share_type":"","_pinterest_share_type":"","_linkedin_share_type_page":"","_instagram_share_type":"","_medium_share_type":"","_threads_share_type":"","_google_business_share_type":"","_selected_social_profile":[],"_wpsp_enable_custom_social_template":false,"_wpsp_social_scheduling":{"enabled":false,"datetime":null,"platforms":[],"status":"template_only","dateOption":"today","timeOption":"now","customDays":"","customHours":"","customDate":"","customTime":"","schedulingType":"absolute"},"_wpsp_active_default_template":true},"categories":[24],"tags":[],"class_list":["post-15436","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-formazione"],"publishpress_future_action":{"enabled":false,"date":"2026-05-16 12:05:13","action":"change-status","newStatus":"draft","terms":[],"taxonomy":"category","extraData":[]},"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=\/wp\/v2\/posts\/15436","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=\/wp\/v2\/users\/1153"}],"replies":[{"embeddable":true,"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=15436"}],"version-history":[{"count":16,"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=\/wp\/v2\/posts\/15436\/revisions"}],"predecessor-version":[{"id":15460,"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=\/wp\/v2\/posts\/15436\/revisions\/15460"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=\/wp\/v2\/media\/15458"}],"wp:attachment":[{"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=15436"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=15436"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.soccorritori.ch\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=15436"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}