The present application discloses systems and methods for the comprehensive monitoring of the microcirculation in order to assess the ultimate efficacy of the cardiovascular system in delivering adequate amounts of oxygen to the organ cells. In some cases, system embodiments may utilize reflectance avoidance by reflectance filtering, such as OPS imaging or Mainstream Dark Field imaging, or by Sidestream Dark Field imaging, which utilizes external direct light on the tip of the light guide to achieve reflectance avoidance whereby incident and reflected light do not travel down the same pathway.