The present application discloses a system and method 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. The system utilizes 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. The system can combine reflectance avoidance with other imaging modalities to provide information regarding perfusion, oxygen saturation and oxygen availability, The system can image the reflectance of a substrate and may include a light source, a light transport body configured to project light from the light source to an examination substrate and transmit light reflected by the examination substrate, and an analysis section in optical communication with the light transport body and having a reflectance avoidance imaging module and at least one of a reflectance spectrophotometry module and a fluorescence imaging module. The method may include utilizing the microcirculatory flow information, the oxygen availability information, and the adequacy of oxygenation of tissue cells information, making an early and sensitive determination regarding states of shock, such as septic, hypovolemic, cardiogenic and obstructive septic shock, in patients, and guiding resuscitation therapies aimed at correcting this condition.Linvention concerne un système et une méthode de surveillance globale de la microcirculation qui permettent dévaluer la capacité ultime du système cardiovasculaire à fournir des quantités adéquates doxygène aux cellules des organes. Le système utilise lannulation de la réflectance par filtrage de la réflectance, telle que limagerie par capteurs optiques ou limagerie en champ noir à courant dominan
