Objective:Poor tissue perfusion/cellular hypoxia may persist despite restoration of the macrocirculation (Macro).This article reviewed the literatures of coherence between hemodynamics and tissue perfusion in circulatory shock.Data sources:We retrieved information from the PubMed database up to January 2018 using various search terms or/and their combinations,including resuscitation,circulatory shock,septic shock,tissue perfusion,hemodynamic coherence,and microcirculation (Micro).Study selection:The data from peer-reviewed joals printed in English on the relationships of tissue perfusion,shock,and resuscitation were included.Results:A binary (coherence/incoherence,coupled/uncoupled,or associated/disassociated) mode is used to describe resuscitation coherence.The phenomenon of resuscitation incoherence (RI) has gained great attention.However,the RI concept requires a more practical,systematic,and comprehensive framework for use in clinical practice.Moreover,we introduce a conceptual framework of RI to evaluate the interrelationship of the Macro,Micro,and cell.The RI is divided into four types (Type 1:Macro-Micro incoherence + impaired cell;Type 2:Macro-Micro incoherence + normal cell;Type 3:Micro-Cell incoherence + normal Micro;and Type 4:both Macro-Micro and Micro-cell incoherence).Furthermore,we propose the concept of dynamic circulation-perfusion coupling to evaluate the relationship of circulation and tissue perfusion during circulatory shock.Contusions:The concept of RI and dynamic circulation-perfusion coupling should be considered in the management of circulatory shock.Moreover,these concepts require further studies in clinical practice.