Sublingual and muscular microcirculatory alterations after cardiac arrest: A pilot study

Donadello, Katia; Favory, Raphaël; Salgado-Ribeiro, Diamantino; Vincent, Jean‐Louis; Gottin, Leonardo; Scolletta, Sabino; Créteur, Jacques; Backer, Daniel De; Taccone, Fabio Silvio

doi:10.1016/j.resuscitation.2011.02.018

Cited by 67 publications

(47 citation statements)

References 35 publications

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“…After cardiac arrest, in the early post resuscitation phase, there are significant microcirculatory abnormalities that return to normal within 48 h [34]. These abnormalities in the early phase closely resemble those abnormalities found in septic shock.…”

Section: Prognostic Value Of Microcirculatory Alterations After Cardimentioning

confidence: 71%

Myocardial Microcirculation and Mitochondrial Energetics in the Isolated Rat Heart

Ashruf

İnce

2016

Advances in Experimental Medicine and Biology

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Section: Prognostic Value Of Microcirculatory Alterations After Cardimentioning

confidence: 71%

Myocardial Microcirculation and Mitochondrial Energetics in the Isolated Rat Heart

Ashruf

İnce

2016

Advances in Experimental Medicine and Biology

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“…There were some considerations about the different trends of hemodynamic and microcirculatory variables in these patients. Several authors demonstrated that macro-and micro-dynamic are not correlated either in septic patients or in patients undergoing cardiac surgery (21)(22)(23)(24). Also, it has been demonstrated that an increase in MAP with norepinephrine infusion may not change microcirculatory function (20).…”

Section: Discussionmentioning

confidence: 99%

“…An inflammatory response syndrome induced by the surgery might also induce changes in microcirculation, as showed in patients undergoing cardiac surgery with or without extracorporeal circulation (24). However, also the general anaesthesia may contribute to the changes on microvascular perfusion, even though its effects are transient (24).…”

Section: Discussionmentioning

confidence: 99%

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Hyperthermic intrathoracic chemotherapy after extended pleurectomy and decortication for malignant pleura mesothelioma: an observational study on outcome and microcirculatory changes

Luzzi¹,

Franchi²,

Dapoto³

et al. 2018

J. Thorac. Dis.

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Background: In the treatment of malignant pleural mesothelioma the Hyperthermic Intra THOracic Chemotherapy (HITHOC) can improve the efficacy of pleurectomy and decortication with a local cytotoxic effect. However its biological impact in patient's hemodynamic and microcirculatory changes were rarely investigated. Aim of this study is to describe our experience with HITHOC after pleurectomy and decortication evaluating the role of sublingual video-microscopy in assessing the microcirculatory changes in the perioperative period. Methods: This is a prospective and observational study concerning 10 consecutive patients undergoing extended P/D followed by HITHOC. These patients underwent sublingual microcirculatory monitoring, which was adopted as a routine procedure since 2012. Haemodynamic parameters were collected at eight consecutive times: the day before surgery (T1), induction of anaesthesia (T2), surgical phase before HITHOC beginning (T3), 5 and 30 minutes after HITHOC start (T4 and T5, respectively), 5 minutes from HITHOC end (T6), after the admission in ICU (T7), at discharge from the ICU (T8). Cardiac output (CO) was calculated with MostCare. Systemic vascular resistance (SVR), oxygen delivery (DO 2 ), and oxygen extraction rate (O 2 ER) were calculated using standard formulas. Arterial blood pressure and central venous pressure (CVP) were obtained with standard arterial and venous catheters. At the same times we assessed the sublingual microcirculation with Sidestream Dark Field technique. Results: Hemodynamic and microcirculatory data were collected in 10 patients, 8 male and 2 females (mean age 68.6±9.0, and body surface area of 1.9±0.1 m 2 ). All patients had arterial hypertension, and one patient had diabetes. The mean arterial pressure significantly decreased at T2, with respect to T1 (P=0.05). CO, CVP, DO2 , O 2 ER, and ScvO 2 , did not change significantly over the time. All patients needed infusion of noradrenalin from T4 to T6. TVD significantly decreased from T1 to T3, T5, and T8. Similarly, PVD significantly decreased from T1 to T3 and T8, and MFI from T1 to T6 and T8. PPV and HI did not change over the study period. No correlation was found between hemodynamic parameters (MAP, CO, CVP, DO 2 , O 2 ER, ScvO 2 ) and microcirculatory data (TVD, PVD, PPV, MFI, HI), at any time of the study. Conclusions: In patients who receive HITHOC the fluid load can reduce the microvascular impairment restoring the normal tissue perfusion. This process takes days but is most evident in the first 72 h. The use of colloid and blood transfusion is much more effective in restoring microcirculation and reducing tissue damaging.

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“…Alterations in the microcirculation are common in critically ill patients with various disease states, including sepsis [1], severe heart failure [2], post-cardiac arrest [3], trauma [4], and abdominal surgery [5]. These alterations usually consist of a decrease in microvascular density, a decrease in the proportion of perfused capillaries, and an increased heterogeneity of tissue perfusion [6].…”

Section: Introductionmentioning

confidence: 99%

Oral Nitrate Increases Microvascular Reactivity and the Number of Visible Perfused Microvessels in Healthy Volunteers

Kolb¹,

Orbegozo²,

Créteur³

et al. 2017

J Vasc Res

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Nitric oxide (NO) plays an important role in controlling microcirculatory function, but the effects of exogenous administration of nitrate (NO₃^-) on the microcirculation have not been well studied. We evaluated whether NO₃^- could influence the microvascular response to hypoxia in 17 healthy volunteers. We used a vascular occlusion test (VOT) to assess the response of near-infrared spectroscopy-derived indexes to hypoxic stress before and 2 h 15 min after oral administration of 800 mg potassium nitrate. We also monitored changes in the sublingual microcirculation using side-stream dark-field (SDF) video microscopy. The descending (7.3 [6.8-8.1] to 8.2 [7.9-9.8] %/min, p = 0.01) and ascending (201 [180-233] to 240 [197-285] %/min, p = 0.01) thenar oxygen saturation (StO₂) slopes were significantly greater during VOT after nitrate administration than before. Sublingual SDF measurements showed increases in the total number of visible perfused vessels (i.e., from 14.1 [13.2-15.5] to 16.3 [15.4-16.7] vessels/mm, p < 0.01) and in the number of visible perfused small vessels (i.e., from 12.2 [11.5-13.7] to 14.2 [13.5-15.3] vessels/mm, p < 0.01) after nitrate administration but no changes in the microvascular flow index or in the proportion of visible perfused vessels, which were already maximal at baseline. Oral administration of nitrate therefore significantly influenced the response to a hypoxic challenge, increasing the number of visible perfused vessels and thus possibly limiting the O₂ diffusion distance.

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Sublingual and muscular microcirculatory alterations after cardiac arrest: A pilot study

Cited by 67 publications

References 35 publications

Myocardial Microcirculation and Mitochondrial Energetics in the Isolated Rat Heart

Myocardial Microcirculation and Mitochondrial Energetics in the Isolated Rat Heart

Hyperthermic intrathoracic chemotherapy after extended pleurectomy and decortication for malignant pleura mesothelioma: an observational study on outcome and microcirculatory changes

Oral Nitrate Increases Microvascular Reactivity and the Number of Visible Perfused Microvessels in Healthy Volunteers

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