Monitoring of the Sublingual Microcirculation in Cardiac Surgery Using Orthogonal Polarization Spectral Imaging

Bauer, Andreas; Kofler, Sieglinde; Thiel, Manfred; Eifert, Sandra; Christ, F.

doi:10.1097/01.anes.0000291442.69337.c9

Cited by 87 publications

(78 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…25 Others showed that cardiac surgery with CPB also was associated with a decreased proportion and density of perfused small vessels, and these observations were irrespective of hemodynamic changes. [80][81][82] In contrast, Maier et al demonstrated that initiation of CPB did not alter sublingual microcirculatory perfusion, while an additional phenylephrine-induced systemic blood pressure increase reduced small vessel blood flow and augmented tissue hemoglobin oxygenation. 52 Others showed that the rectal microvascular flow index and the proportion of perfused vessels was almost normal at 30 minutes following cardiac surgery.…”

Section: Cardiac Surgery With Cardiopulmonary Bypassmentioning

confidence: 99%

Changes in Microcirculatory Perfusion and Oxygenation During Cardiac Surgery With or Without Cardiopulmonary Bypass

Koning

Atasever

Vonk

et al. 2014

Journal of Cardiothoracic and Vascular Anesthesia

View full text Add to dashboard Cite

Section: Cardiac Surgery With Cardiopulmonary Bypassmentioning

confidence: 99%

Changes in Microcirculatory Perfusion and Oxygenation During Cardiac Surgery With or Without Cardiopulmonary Bypass

Koning

Atasever

Vonk

et al. 2014

Journal of Cardiothoracic and Vascular Anesthesia

View full text Add to dashboard Cite

“…Bauer et al [115] first reported that microcirculatory perfusion was transiently altered in humans after cardiopulmonary bypass. Similar findings were reported more recently by other groups [116,117].…”

Section: High-risk Surgerymentioning

confidence: 99%

Monitoring the microcirculation in the critically ill patient: current methods and future approaches

et al. 2010

View full text Add to dashboard Cite

show abstract

“…This FCD normalized one hour after discontinuation of CPB and was correlated with hemoglobin concentration and body temperature. Rolling of leukocytes was increased threefold one hour after discontinuation of CPB (46) . Other reports suggest that these abnormalities may persist for a longer period of time (47) .…”

Section: Cardiopulmonary Bypassmentioning

confidence: 97%

Microcirculatory assessment in daily clinical practice - not yet ready but not too far!

Salgado

Favory

Backer

2010

Einstein (São Paulo)

View full text Add to dashboard Cite

Shock is characterized by an alteration in tissue perfusion that may lead to tissue hypoxia. Recent guidelines recommend aggressive and early resuscitation therapy, but mortality rate is still unacceptably high. Unfortunately, traditional clinical surrogates used to guide resuscitation therapy poorly correlate with microcirculatory blood flow, a key determinant of tissue perfusion. New techniques that directly assess microcirculatory perfusion at the bedside have emerged as a complement to traditional macrohemodynamic parameters. These techniques have been supported by several studies showing microcirculatory alterations in different clinical settings. In addition, these microcirculatory alterations are related with outcome and persist regardless of arterial pressure normalization, being a better predictor of organ dysfunction and mortality than global hemodynamic and laboratory parameters. These findings allowed the concept of "microcirculatory-goal directed therapy", which is now in its preliminary phase, as the impact of many interventions still needs to be assessed. Finally, microcirculation assessment has also been explored in other medical fields such as perioperative, systemic arterial hypertension, heart failure, and hyperviscosity syndromes. In this review, we shortly present the characteristics of microcirculation and the main determinants of capillary blood flow, and we discuss advantages and limitations of some recently available techniques to evaluate microcirculation at the bedside, and how they could be useful for the general clinician in daily practice.Keywords: Shock; Resuscitation; Microcirculation/pathophysiology; Hemodynamics/physiology; Multiple organ failure/pathophysiology; Prognosis ReSUMOO choque é caracterizado por uma alteração na perfusão tecidual que pode levar à hipóxia tecidual. Diretrizes recentes recomendam uma terapia de ressuscitação hemodinâmica precoce e agressiva nos estados de choque, mas a taxa de mortalidade ainda é inaceitavelmente alta. Os parâmetros clínicos habituais usados para orientar a terapia de reanimação correlacionam-se mal com o fluxo sanguíneo capilar, um determinante essencial da perfusão tecidual. Novas técnicas que avaliam diretamente a perfusão da microcirculação à beira do leito surgem como um complemento aos parâmetros macro-hemodinâmicos tradicionais. Estas técnicas foram testadas em vários estudos que mostraram alterações microcirculatórias em diferentes situações clínicas de choque. Além disso, estas alterações microcirculatórias estão relacionadas ao prognóstico, e persistem independentemente da normalização da pressão arterial, sendo um melhor preditor de disfunção orgânica e mortalidade do que os parâmetros hemodinâmicos globais e laboratoriais. Estes achados permitiram lançar o conceito de "terapia dirigida por parâmetros microcirculatórios", atualmente em fase preliminar, uma vez que o impacto de muitas intervenções ainda precisa ser avaliado. Finalmente, a avaliação da microcirculação também foi explorada em outras áreas que não o choq...

show abstract

Monitoring of the Sublingual Microcirculation in Cardiac Surgery Using Orthogonal Polarization Spectral Imaging

Cited by 87 publications

References 30 publications

Changes in Microcirculatory Perfusion and Oxygenation During Cardiac Surgery With or Without Cardiopulmonary Bypass

Changes in Microcirculatory Perfusion and Oxygenation During Cardiac Surgery With or Without Cardiopulmonary Bypass

Monitoring the microcirculation in the critically ill patient: current methods and future approaches

Microcirculatory assessment in daily clinical practice - not yet ready but not too far!

Contact Info

Product

Resources

About