Direct oxymetric peripheral tissue perfusion monitoring during open heart surgery with the use of cardiopulmonary bypass: preliminary experience

Lonský, Vladimír; Svitek, Vladimir; Brzek, V; Kubícek, J; Volt, Martin; Horak, Miroslav; Mandak, Jiri

doi:10.1177/0267659111419272

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…Even if autoregulation system well regulates to maintain peripheral tissue circulation, CPB perfusion pressure seems to be more important to prevent peripheral tissue hypoperfusion under nonpulsatile flow. Recently, study suggested that not only high perfusion flow but also high perfusion pressure was necessary during CPB to protect the skeletal muscle [ 20 ]. It remains controversial which is more important for management of CPB, pressure, or flow.…”

Section: Resultsmentioning

confidence: 99%

Lactate level during cardiopulmonary bypass as a predictor of postoperative outcomes in adult patients undergoing cardiac surgery

et al. 2016

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BackgroundIt has been reported that prolonged intensive care unit (ICU) stay after cardiac surgery is associated with poor patient outcome. In addition, prolonged stay can block the efficient use of ICU beds with an increase in expenditure of health-care costs. The aim of the present study was to retrospectively determine which pre- and intra-operative factors could significantly affect ICU-free survival days (IFSD) which has been suggested to reflect postoperative patients’ outcome, as well as variables significantly associated with the main predictors of IFSD.FindingsWe reviewed anesthesia charts and medical records of 145 patients undergoing cardiac surgery under cardiopulmonary bypass (CPB) in our hospital from January 2014 to October 2015, and 72 patients’ records were finally used for the analysis. IFSD was a median of 25 days (95% CI 24–26). The multiple regression analysis indicated that preoperative estimated glomerular filtration rate, differences between preoperative mean arterial pressure and mean CPB pressure, and blood lactate level at 2 h after CPB (CPB-2 h) were independently associated with IFSD (β regression coefficients 0.086, −0.083, and −3.601, respectively).ConclusionIn addition to preoperative renal function and differences between preoperative MAP and CPB pressure, the lactate level at CPB-2 h could be a major predictor of postoperative outcome in patients undergoing cardiac surgery.

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Section: Resultsmentioning

confidence: 99%

Lactate level during cardiopulmonary bypass as a predictor of postoperative outcomes in adult patients undergoing cardiac surgery

et al. 2016

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“…Importantly, these methods rely on adequate perfusion to deliver the desired changes to the local surgical area, which can be difficult to achieve during an operation. A preliminary study, looking at tissue perfusion during surgery, reported a decrease in tissue perfusion and oxygen tension following the administration of anaesthetics [ 14 ]. Therefore, a locally targeted intervention that could increase local wound perfusion, and thus oxygenation, may be more clinically successful in surgical patients.…”

Section: Introductionmentioning

confidence: 99%

Increased visceral tissue perfusion with heated, humidified carbon dioxide insufflation during open abdominal surgery in a rodent model

et al. 2018

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Tissue perfusion during surgery is important in reducing surgical site infections and promoting healing. This study aimed to determine if insufflation of the open abdomen with heated, humidified (HH) carbon dioxide (CO2) increased visceral tissue perfusion and core body temperature during open abdominal surgery in a rodent model. Using two different rodent models of open abdominal surgery, visceral perfusion and core temperature were measured. Visceral perfusion was investigated using a repeated measures crossover experiment with rodents receiving the same sequence of two alternating treatments: exposure to ambient air (no insufflation) and insufflation with HH CO2. Core body temperature was measured using an independent experimental design with three treatment groups: ambient air, HH CO2 and cold, dry (CD) CO2. Visceral perfusion was measured by laser speckle contrast analysis (LASCA) and core body temperature was measured with a rectal thermometer. Insufflation with HH CO2 into a rodent open abdominal cavity significantly increased visceral tissue perfusion (2.4 perfusion units (PU)/min (95% CI 1.23–3.58); p<0.0001) compared with ambient air, which significantly reduced visceral blood flow (-5.20 PU/min (95% CI -6.83- -3.58); p<0.0001). Insufflation of HH CO2 into the open abdominal cavity significantly increased core body temperature (+1.15 ± 0.14°C) compared with open cavities exposed to ambient air (-0.65 ± 0.52°C; p = 0.037), or cavities insufflated with CD CO2 (-0.73 ± 0.33°C; p = 0.006). Abdominal visceral temperatures also increased with HH CO2 insufflation compared with ambient air or CD CO2, as shown by infrared thermography. This study reports for the first time the use of LASCA to measure visceral perfusion in open abdominal surgery and shows that insufflation of open abdominal cavities with HH CO2 significantly increases visceral tissue perfusion and core body temperature.

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Direct oxymetric peripheral tissue perfusion monitoring during open heart surgery with the use of cardiopulmonary bypass: preliminary experience

Cited by 2 publications

References 11 publications

Lactate level during cardiopulmonary bypass as a predictor of postoperative outcomes in adult patients undergoing cardiac surgery

Lactate level during cardiopulmonary bypass as a predictor of postoperative outcomes in adult patients undergoing cardiac surgery

Increased visceral tissue perfusion with heated, humidified carbon dioxide insufflation during open abdominal surgery in a rodent model

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