[Monitoring renal microcirculation perfusion alteration with contrast-enhanced ultrasound during cardiopulmonary bypass]
Related Experiment Video
Updated: May 7, 2026
Continuous Venous-Arterial Doppler Ultrasound During a Preload Challenge
Published on: January 20, 2023
Xiao-Fei Zhong1, Da Zhu, Qiang Lu
1Departement of Ultrasound, West China Hospital, Sichuan University, Chengdu 610041, China.
Insights
Contrast-enhanced ultrasound (CEU) reveals significant reductions in renal perfusion during cardiopulmonary bypass (CPB) in pediatric patients. This imaging technique effectively monitors changes in kidney microcirculation during cardiac surgery.
Area of Science:
- Nephrology
- Cardiovascular Surgery
- Medical Imaging
Background:
- Cardiopulmonary bypass (CPB) is a critical procedure in pediatric cardiac surgery.
- Monitoring renal microcirculation during CPB is essential for patient outcomes.
- Contrast-enhanced ultrasound (CEU) offers a non-invasive method for assessing tissue perfusion.
Purpose of the Study:
- To evaluate the utility of CEU in monitoring renal microcirculation.
- To assess alterations in renal perfusion during CPB.
- To investigate regional differences in renal perfusion during CPB.
Main Methods:
- Renal microcirculation perfusion was assessed using CEU before and during CPB.
- Time-intensity curves (TICs) were generated from three regions of interest (ROIs).
- Perfusion parameters including wash-in slope (A), area under the curve (AUC), peak intensity (DPI), and time to peak intensity (TTP) were calculated.
Main Results:
- CEU demonstrated a significant reduction or elongation of perfusion parameters (A, AUC, DPI, TTP) across all renal regions (superficial cortex, deep cortex, medulla) during CPB.
- These changes were compared to perfusion during a normal cardiac cycle.
- A global reduction in renal perfusion and significant regional differences were observed.
Conclusions:
- CPB significantly impacts renal microcirculation in pediatric patients.
- CEU is capable of detecting these alterations in renal microcirculation during CPB.
- The findings highlight the importance of monitoring renal perfusion during CPB.
Objective:
To investigate the monitoring of renal microcirculation perfusion alteration with contrast-enhanced ultrasound (CEU) during cardiopulmonary bypass (CPB).
Methods:
Renal microcirculation perfusion before and during CPB was assessed by CEU. Time-intensity curve (TIC) were derived from three region of interest (ROI) using QLAB post-analysis software. Parameters such as TIC curve wash in slope (A), area under curve (AUC), peak intensity (DPI) as well as time to peak intensity (TTP) were then calculated.
Results:
Contrast-enhanced ultrasound showed a significant reduction (or elongation) of perfusion parameter (A, AUC, DPI, TTP) in all three regions (superficial cortex, deep cortex and medulla) during cardiopulmonary bypass in comparison with normal cardiac cycle.
Conclusion:
Cardiopulmonary bypass (CPB) has a dramatic impact on renal microcirculation in pediatric patients which manifest as global reduction in renal perfusion as well as significant region perfusion difference. Contrast-enhanced ultrasound (CEU) could detect the renal microcirculation alteration during CPB.
