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Published on: November 28, 2018
Perioperative trajectory of plasma viscosity: A prospective, observational, exploratory study in cardiac surgery
Liana Valeanu1, Stefan Andrei2,3, Carmen Ginghina4,5
1Cardiac Anesthesiology and Intensive Care Department I, Emergency Institute for Cardiovascular Diseases Prof. dr. C. C. Iliescu, Bucharest, Romania.
Insights
Plasma viscosity, crucial for microcirculatory flow, is tightly regulated during cardiac surgery. While influenced by proteins, it showed minimal perioperative changes, suggesting its stability in this context.
Area of Science:
- Cardiovascular Science
- Hemodynamics
- Biomedical Engineering
Background:
- Plasma viscosity is a key factor in microcirculatory flow, yet it remains under-researched.
- Understanding its behavior during cardiac surgery is essential for optimizing patient outcomes.
Purpose of the Study:
- To evaluate plasma viscosity in cardiac surgery patients.
- To analyze its perioperative trajectory, key determinants, and impact on outcomes.
Main Methods:
- A prospective, single-center observational study of 50 adult cardiac surgery patients.
- Collected data on clinical characteristics, outcomes, and blood parameters at 10 time points.
- Measured plasma viscosity, total proteins, and fibrinogen concentrations.
Main Results:
- Plasma viscosity is significantly influenced by protein concentrations and measurement timing.
- It exhibited low coefficients of variation and minimal percentage changes compared to hemoglobin, fibrinogen, and total proteins.
- No association between plasma viscosity and short-term outcomes was detected, possibly due to study power limitations.
Conclusions:
- Plasma viscosity demonstrates tight regulation and stability during the perioperative period in cardiac surgery.
- Larger patient cohorts are necessary to investigate potential links between plasma viscosity and clinical outcomes.
Objective:
Plasma viscosity is one of the critical factors that regulate microcirculatory flow but has received scant research attention. The main objective of this study was to evaluate plasma viscosity in cardiac surgery with respect to perioperative trajectory, main determinants, and impact on outcome.
Methods:
Prospective, single center, observational study, including 50 adult patients undergoing cardiac surgery with cardiopulmonary bypass between February 1, 2020 and May 31, 2021. Clinical perioperative characteristics, short term outcome, standard blood analysis, plasma viscosity, total proteins, and fibrinogen concentrations were recorded at 10 distinct time points during the first perioperative week.
Results:
The longitudinal analysis showed that plasma viscosity is strongly influenced by proteins and measurement time points. Plasma viscosity showed a coefficient of variation of 11.3 ± 1.08 for EDTA and 12.1 ± 2.1 for citrate, similarly to total proteins and hemoglobin, but significantly lower than fibrinogen (p < .001). Plasma viscosity had lower percentage changes compared to hemoglobin (RANOVA, p < .001), fibrinogen (RANOVA, p < .001), and total proteins (RANOVA, p < .001). The main determinant of plasma viscosity was protein concentrations. No association with outcome was found, but the study may have been underpowered to detect it.
Conclusion:
Plasma viscosity had a low coefficient of variation and low perioperative changes, suggesting tight regulation. Studies linking plasma viscosity with outcome would require large patient cohorts.
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