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Cutaneous microcirculation during operations with a cardiopulmonary bypass

Lars Saemann1, Folker Wenzel1

  • 1Faculty Medical and Life Science, Furtwangen University, Villingen-Schwenningen, Germany.

Clinical Hemorheology and Microcirculation
|April 10, 2018
PubMed

Insights

Cutaneous microcirculation (cMC) during cardiac surgery is affected by cardiopulmonary bypass (CPB). Laser-Doppler-Perfusion (LDP) monitoring offers a non-invasive way to assess hemodynamic changes during heart surgery.

Area of Science:

  • Cardiovascular Surgery
  • Physiology
  • Medical Monitoring

Background:

  • Cardiac surgery frequently involves cardiopulmonary bypass (CPB) and induced cardiac arrest.
  • Cutaneous microcirculation (cMC) is a critical physiological parameter affected by surgical interventions.

Purpose of the Study:

  • To investigate the relationship between cMC and hemodynamic parameters in cardiac surgery patients.
  • To compare the effects of two distinct cardioplegic solutions on cMC.

Main Methods:

  • Twenty patients undergoing cardiac surgery were divided into two groups: Histidine-Tryptophane-α-Ketoglutarate (HTK) solution and blood cardioplegia (BCP).
  • Continuous monitoring of cMC using Laser-Doppler-Perfusion (LDP) was performed throughout CPB.
  • Hemoglobin concentration (HbC) was measured using a Blood-Parameter-Monitoring-System.

Main Results:

  • LDP levels decreased during aortic cross-clamping and were influenced by central venous pressure, mean arterial pressure, and total peripheral resistance.
  • Patients receiving BCP exhibited higher relative LDP (RLDP) and relative HbC (RHbC) compared to the HTK group post-cardioplegia administration.
  • HTK patients with a body surface area (BSA) < 2 m² showed lower RLDP than those with BSA ≥ 2 m².

Conclusions:

  • Cardiopulmonary bypass significantly impacts cMC during cardiac surgery.
  • Cutaneous LDP monitoring serves as a valuable non-invasive tool for intraoperative hemodynamic assessment.
Abstract

Keywords:
BretschneiderCalafioreExtracorporeal circulationLaser-Doppler-FlowLaser-Doppler-Perfusioncardioplegiacardiopulmonary bypassheart-lung machinehemodynamicsmicrocirculation

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