Sublingual microcirculation in patients with intra-abdominal hypertension: A pilot study in 15 critically ill patients

Maddison, Liivi; Karjagin, Juri; Buldakov, Maksim; Mäll, Merilin; Kruusat, Rein; Lillemäe, Kadri; Kirsimägi, Ülle; Starkopf, Joel

doi:10.1016/j.jcrc.2013.08.018

Cited by 6 publications

(2 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on present study we may speculate that short-term moderate increase of IAP has no significant impact of splanchnic circulation. Preliminary results from our parallel study also confirm that IAH at grades I and II has only a negligible influence upon sublingual microcirculation on previously fluid-resuscitated ICU patients [24]. Interestingly, in those ICU patients PPV was 80% at the baseline with no changes during the observation period of 144 hours [24].…”

Section: Discussionsupporting

confidence: 75%

“…Preliminary results from our parallel study also confirm that IAH at grades I and II has only a negligible influence upon sublingual microcirculation on previously fluid-resuscitated ICU patients [24]. Interestingly, in those ICU patients PPV was 80% at the baseline with no changes during the observation period of 144 hours [24]. Patients in current study were scheduled for elective surgery; they were relatively healthy and had no serious organ dysfunctions.…”

Section: Discussionsupporting

confidence: 73%

See 1 more Smart Citation

Sublingual microcirculatory changes during transient intra-abdominal hypertension – A prospective observational study in laparoscopic surgery patients

Maddison

Riigor

Karjagin

et al. 2014

Clinical Hemorheology and Microcirculation

Self Cite

View full text Add to dashboard Cite

BACKGROUND: Microvascular alterations and intra-abdominal hypertension are both involved in development of organ failure. It is not known whether increased intra-abdominal pressure (IAP) is associated with microcirculatory perfusion derangements. HYPOTHESIS: Transient increase in IAP induced by pneumoperitoneum affects sublingual microcirculation. METHODS: 16 laparoscopic cholecystectomy patients were studied. Sidestream dark field (SDF) imaging was used to evaluate sublingual microcirculation. Microcirculatory videos were done before surgery, at least 15 minutes after initiation of pneumoperitoneum and 1 hour after the pneumoperitoneum. Microcirculation cut-off value for vessels was 20 m. RESULTS: IAP was held at 12.6 (from 12 to 14) mmHg, mean (SD) duration of pneumoperitoneum was 41 (14) minutes. At the baseline, mean total vascular density was 18.8 (2.6) and perfused vessel density 13.2 (2.9) per mm 2 . Proportion of perfused vessels was 59 (11) % and microvascular flow index 2.2 (0.4). Median (IQR) heterogeneity index was 0.6 (0.4-0.9) and mean De Backer score 13.6 (1.5). Increase in IAP did not cause significant changes in sublingual microcirculatory parameters. CONCLUSIONS: Transiently increased IAP due to pneumoperitoneum does not affect sublingual microcirculatory blood flow and vessel density in patients undergoing laparoscopic surgery. However, the low proportion of perfused vessels indicates the prevalence of perioperative microcirculatory deficiency in these patients.

show abstract

Section: Discussionsupporting

confidence: 75%

Section: Discussionsupporting

confidence: 73%