科研之友
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摘要
Objective: This study investigated the perioperative course of microcirculatory perfusion in off-pump compared with on-pump surgery. Additionally, the impact of changes in systemic hemodynamics, hematocrit, and body temperature was studied. %26lt;br%26gt;Design: Prospective, nonrandomized, observational study. %26lt;br%26gt;Setting: Tertiary university hospital. %26lt;br%26gt;Participants: Patients undergoing coronary artery bypass grafting with (n = 13) or without (n = 13) use of cardiopulmonary bypass. %26lt;br%26gt;Interventions: Microcirculatory measurements were obtained at 5 time points ranging from induction of anesthesia to ICU admission. %26lt;br%26gt;Measurements and Main Results: Microcirculatory recordings were performed with sublingual sidestream dark field imaging. Despite a comparable reduction in intraoperative blood pressure between groups, the perfused vessel density decreased more than 20% after onset of extracorporeal circulation but remained stable in the off-pump group. The reduction in microvascular perfusion in the on-pump group was further paralleled by decreased hematocrit and temperature; Although postbypass hematocrit levels and body temperature were restored to similar levels as in the off-pump group, the median microvascular flow index remained reduced after bypass (2.4 [2.3-2.7]) compared with baseline (2.8 [2.7-2.9]; p = 0.021). %26lt;br%26gt;Conclusions: Microcirculatory perfusion remained unaltered throughout off-pump surgery. In contrast, microvascular perfusion declined after initiation of cardiopulmonary bypass and did not recover in the early postoperative phase.
- 出版日期2014-4
