Please see Bibliography of References for a list of abstracts, manuscripts and posters.
Castilho MA, Buechele GL, Sales Jr JA, Ospina-Tascon GA, Oliveira TA, Creteur J, Vincent JL. Crit Care Med. 2006;34(12, Abstract Supplement):A59. Abstract 225.
Introduction: Patients submitted a cardiac surgery with cardiopulmonary bypass (CPB) present an inflammatory response that may be associated with microvascular alteration.
Hypothesis: Cardiac surgery with CPB may alters the microvascular response during reactive hyperemia test.
Methods: We analyzed the microvascular response during reactive hyperemia test in 17 patients after cardiac surgery with CPB and in l8 healthy volunteers. Tissue oxygen saturation( StiO2) was measured using near-infrared spectroscopy (InSpectra 325) in the thenar eminence for three minutes after arterial occlusion. Vasoreactivity was assessed by the calculation of the increase of StiO2 (slope) during the first I7.5 seconds after release of the arterial occlusion. In the CPB group the measures were made at ICU admission (T1, hypothermia and sedation), when normothermia was achieved, under sedation (T2), just before extubation (T3) and 24h thereafter (T4). Patients with respiratory and hemodynamic complications in the postoperative period were excluded.
Results: The CBP group (median age 75 yrs) included valvular replacement in 12 and coronary artery bypass graft in 5. The the CPB group slope was significantly lower in each time than in healthy controls (Fig. 1).
Conclusions: These observations suggest that microvascular reactivity is altered after cardiac surgery with CPB and remains altered for 24 hours.