Effects of anesthetics on microvascular reactivity measured by vascular occlusion tests during off-pump coronary artery bypass surgery: a randomized controlled trial

Cho, Youn Joung; Yoo, Sol Ji; Nam, Karam; Bae, Jin Young; Lee, Seo Hee; Jeon, Yunseok

doi:10.1007/s10877-020-00587-8

Cited by 3 publications

(2 citation statements)

References 22 publications

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“…The RA decreased after anesthesia induction with either diazepam and fentanyl [23] or propofol and sufentanil [25], although the RA increased after induction with midazolam and sufentanil [24]. When comparing different anesthetic drugs for maintenance of anesthesia, no differences in the VOT-derived NIRS values were found comparing propofol and fentanyl with sevoflurane and fentanyl [26], or desflurane and remifentanil with sevoflurane and remifentanil [27]. Maintenance with either desflurane or sevoflurane gave a similar decrease in the StO 2 and the RA at the end of surgery compared to pre-induction baseline values [27].…”

Section: Effects Of Anesthetics and Other Drugsmentioning

confidence: 87%

The use of a vascular occlusion test combined with near-infrared spectroscopy in perioperative care: a systematic review

Niezen

Massari

Vos

et al. 2022

J Clin Monit Comput

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In the perioperative phase oxygen delivery and consumption can be influenced by different factors, i.e. type of surgery, anesthetic and cardiovascular drugs, or fluids. By combining near-infrared spectroscopy (NIRS) monitoring of regional tissue oxygen saturation (StO 2 ) with an ischemic provocation test, the vascular occlusion test (VOT), local tissue oxygen consumption and vascular reactivity at the microcirculatory level can be assessed. This systematic review aims to give an overview of the clinical information that VOT-derived NIRS values can provide in the perioperative period. After performing a systematic literature search, we included 29 articles. It was not possible to perform a meta-analysis because of the lack of comparable data and the observational nature of the majority of the included articles. We have clustered the found articles in two groups: non-cardiac surgery and cardiac surgery. We found that VOT-derived NIRS values show a wide variability and are influenced by the effects of anesthetics, cardiovascular drugs, fluids, and by the type of surgery. Additionally, deviations in VOT-derived NIRS values are also associated with adverse patients' outcomes, such as postoperative complications, prolonged mechanical ventilation and prolonged hospital length of stay. However, given the variability in VOT-derived NIRS values, clinical applicability remains elusive. Future clinical interventional trials might provide additional insight into the potential of VOT associated with NIRS to optimize perioperative care by targeting specific interventions to optimize the function of the microvasculature.

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Section: Effects Of Anesthetics and Other Drugsmentioning

confidence: 87%

The use of a vascular occlusion test combined with near-infrared spectroscopy in perioperative care: a systematic review

Niezen

Massari

Vos

et al. 2022

J Clin Monit Comput

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“…Previously, Cho and colleagues [45] had demonstrated that the microvascular circulation, estimated using thenar rSO 2 measurement during a VOT, is less affected by general anesthesia with desflurane-remifentanil compared to propofol-remifentanil anesthesia in patients undergoing thoracoscopic surgery [6]. In an article published in the October 2021 edition of JCMC [46], they conducted a similar study comparing the effects of desflurane vs. sevoflurane-based anesthesia on microvascular reactivity in patients undergoing off-pump coronary artery bypass graft surgery. Thenar rSO 2 was monitored and VOTs were performed before induction of anesthesia, before and after a coronary artery anastomosis, and at the end of surgery.…”

Section: Tissue Oxygenation and Neuropsychological Functioningmentioning

confidence: 99%

What is new in microcirculation and tissue oxygenation monitoring?

Keijzer

Massari

Sahinovic

et al. 2022

J Clin Monit Comput

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Ensuring and maintaining adequate tissue oxygenation at the microcirculatory level might be considered the holy grail of optimal hemodynamic patient management. However, in clinical practice we usually focus on macro-hemodynamic variables such as blood pressure, heart rate, and sometimes cardiac output. Other macro-hemodynamic variables like pulse pressure or stroke volume variation are additionally used as markers of fluid responsiveness. In recent years, an increasing number of technological devices assessing tissue oxygenation or microcirculatory blood flow have been developed and validated, and some of them have already been incorporated into clinical practice. In this review, we will summarize recent research findings on this topic as published in the last 2 years in the Journal of Clinical Monitoring and Computing (JCMC). While some techniques are already currently used as routine monitoring (e.g. cerebral oxygenation using near-infrared spectroscopy (NIRS)), others still have to find their way into clinical practice. Therefore, further research is needed, particularly regarding outcome measures and cost-effectiveness, since introducing new technology is always expensive and should be balanced by downstream savings. The JCMC is glad to provide a platform for such research.

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Research Progress of Desflurane on Perioperative Myocardial Protection

智¹

2022

ACM

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Effects of anesthetics on microvascular reactivity measured by vascular occlusion tests during off-pump coronary artery bypass surgery: a randomized controlled trial

Cited by 3 publications

References 22 publications

The use of a vascular occlusion test combined with near-infrared spectroscopy in perioperative care: a systematic review

The use of a vascular occlusion test combined with near-infrared spectroscopy in perioperative care: a systematic review

What is new in microcirculation and tissue oxygenation monitoring?

Research Progress of Desflurane on Perioperative Myocardial Protection

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