Association between serosal intestinal microcirculation and blood pressure during major abdominal surgery

Tavy, A. L. M.; Bruin, Anton Fj de; Boerma, E. Christiaan; İnce, Can; Hilty, Matthias P.; Noordzij, Peter G.; Boerma, Djamila; Iterson, Mat van

doi:10.1016/j.jointm.2021.03.003

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…In a prospective observational study evaluating the relationship between global oxygen delivery, microcirculatory flow, and tissue oxygenation in patients having major abdominal surgery, impairment of microcirculatory flow was most apparent in patients who developed complications, especially in patients who had long operations for reasons that remain unclear. 23,24 Thus, while sublingual microcirculatory alterations are thought to reflect splanchnic microcirculatory perfusion, [8][9][10]23,25 the relationship between splanchnic perfusion and substantive outcomes remains unclear. It is possible, for example, that solid organs are more sensitive to hypotension and cause most hypotensionrelated complications.…”

Section: Discussionmentioning

confidence: 99%

Association between mean arterial pressure and sublingual microcirculation during major non‐cardiac surgery: Post hoc analysis of a prospective cohort

et al. 2023

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Objective To test the hypothesis that there is an association between mean arterial pressure (MAP) and sublingual perfusion during major surgery, and perhaps an identifiable harm threshold. Methods This post hoc analysis of a prospective cohort included patients who had elective major non‐cardiac surgery with a duration of ≥2 h under general anesthesia. We assessed sublingual microcirculation every 30 min using SDF+ imaging and determined the De Backer score, Consensus Proportion of Perfused Vessels (Consensus PPV), and the Consensus PPV (small). Our primary outcome was the relationship between MAP and sublingual perfusion which was evaluated with linear mixed effects modeling. Results A total of 100 patients were included, with MAP ranging between 65 mmHg and 120 mmHg during anesthesia and surgery. Over a range of intraoperative MAPs between 65 and 120 mmHg, there were no meaningful associations between blood pressure and various measures of sublingual perfusion. There were also no meaningful changes in microcirculatory flow over 4.5 h of surgery. Conclusions In patients having elective major non‐cardiac surgery with general anesthesia, sublingual microcirculation is well maintained when MAP ranges between 65 and 120 mmHg. It remains possible that sublingual perfusion will be a useful marker of tissue perfusion when MAP is lower than 65 mmHg.

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Section: Discussionmentioning

confidence: 99%

Association between mean arterial pressure and sublingual microcirculation during major non‐cardiac surgery: Post hoc analysis of a prospective cohort

et al. 2023

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“…ICG angiography captures the immediate transit of the fluorescence dye through the vasculature, so the ICG perfusion parameter may not perfectly match with the tissue oxygenation status. Additionally, tissue oxygenation levels can be influenced by factors such as oxygen consumption, local metabolism, and tissue perfusion dynamics, which may not be directly reflected in ICG perfusion parameters [17][18][19]. Therefore, the measurement of tissue StO 2 will be beneficial for assessing whether adequate blood flow reaches tissue microcirculation levels [20].…”

Section: Discussionmentioning

confidence: 99%

The Safe Values of Quantitative Perfusion Parameters of ICG Angiography Based on Tissue Oxygenation of Hyperspectral Imaging for Laparoscopic Colorectal Surgery: A Prospective Observational Study

et al. 2023

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Background: Safe values for quantitative perfusion parameters of indocyanine green (ICG) angiography have not been fully defined, and interpretation remains at the surgeon’s discretion. This prospective observational study aimed to establish the safe values for the quantitative perfusion parameters by comparing tissue oxygenation levels from HSI images in laparoscopic colorectal surgery. Methods: ICG angiography was performed using a laparoscopic near-infrared (NIR) camera system with ICG diluted in 10 mL of distilled water. For quantitative perfusion parameters, the changes in fluorescence intensity with perfusion times were analyzed to plot a time–fluorescence intensity graph. To assess real-time tissue oxygen saturation (StO2) in the colon, the TIVITA® Tissue System was utilized for hyperspectral imaging (HSI) acquisition. The StO2 levels were compared with the quantitative perfusion parameters derived from ICG angiography at corresponding points to define the safe range of ICG parameters reflecting good tissue oxygenation. Results: In the regression analysis, T1/2MAX, TMAX, slope, and NIR perfusion index were correlated with tissue oxygen saturation. Using this regression model, the cutoff values of quantitative perfusion parameters were calculated as T1/2MAX ≤ 10 s, TMAX ≤ 30 s, slope ≥ 5, and NIR perfusion index ≥50, which best reflected colon StO2 higher than 60%. Diagnostic values were analyzed to predict colon StO2 of 60% or more, and the ICG perfusion parameters T1/2MAX, TMAX, and perfusion TR showed high sensitivity values of 97% or more, indicating their ability to correctly identify cases with acceptable StO2. Conclusion: The safe values for quantitative perfusion parameters derived from ICG angiography were T1/2MAX ≤ 10 s and TMAX ≤ 30 s, which were associated with colon tissue oxygenation levels higher than 60% in the laparoscopic colorectal surgery.

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“…Notably, there is widespread consensus that ischemic injury and severe microcirculatory dysfunction in the highly vascularized gut are significant sources of multiple organ dysfunction and even death[ 9 , 10 ]. Moreover, the intestinal microcirculation behaves as an isolated area in patients with postoperative abdominal sepsis[ 11 ], suggesting that the intestinal microcirculation does not always correlate with systemic hemodynamic variables (for example, blood pressure)[ 12 ] in gastrointestinal diseases. Therefore, it is rational to have a comprehensive scenario that depicting the functional status of intestinal microcirculation in discussing the specific issues.…”

Section: Introductionmentioning

confidence: 99%

Global trend and future landscape of intestinal microcirculation research from 2000 to 2021: A scientometric study

Fu¹,

Xu²,

Wang³

et al. 2023

World J Gastroenterol

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BACKGROUND The intestinal microcirculation functions in food absorption and metabolic substance exchanges. Accumulating evidence indicates that intestinal microcirculatory dysfunction is a significant source of multiple gastrointestinal diseases. To date, there has not been a scientometric analysis of intestinal microcirculatory research. AIM To investigate the current status, development trends, and frontiers of intestinal microcirculatory research based on bibliometric analysis. METHODS VOSviewer and CiteSpace 6.1.R2 were used to identify the overall characteristics and knowledge map of intestinal microcirculatory research based on the core literature published from 2000 to 2021 in the Web of Science database. The characteristics of each article, country of origin, institution, journal, cocitations, and other information were analyzed and visualized. RESULTS There were 1364 publications enrolled in the bibliometric analysis, exhibiting an upward trend from 2000 to 2021 with increased participation worldwide. The United States and Dalhousie University took the lead among countries and institutions, respectively. Shock was the most prolific journal, and Nature Reviews Microbiology Clinical had the most citations. The topical hotspots and frontiers in intestinal microcirculatory research were centered on the pathological processes of functional impairment of intestinal microvessels, diverse intestinal illnesses, and clinical treatment. CONCLUSION Our study highlights insights into trends of the published research on the intestinal microcirculation and offers serviceable guidance to researchers by summarizing the prolific areas in intestinal disease research to date.

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Association between serosal intestinal microcirculation and blood pressure during major abdominal surgery

Cited by 5 publications

References 17 publications

Association between mean arterial pressure and sublingual microcirculation during major non‐cardiac surgery: Post hoc analysis of a prospective cohort

Association between mean arterial pressure and sublingual microcirculation during major non‐cardiac surgery: Post hoc analysis of a prospective cohort

The Safe Values of Quantitative Perfusion Parameters of ICG Angiography Based on Tissue Oxygenation of Hyperspectral Imaging for Laparoscopic Colorectal Surgery: A Prospective Observational Study

Global trend and future landscape of intestinal microcirculation research from 2000 to 2021: A scientometric study

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