Article
Effectiveness of Laser Doppler Perfusion Monitoring in the Assessment of Microvascular Function in Patients Undergoing On-Pump Coronary Artery Bypass Grafting
Registro en:
SALGADO, Maria A. M. et al. Effectiveness of Laser Doppler Perfusion Monitoring in the Assessment of Microvascular Function in Patients Undergoing On-Pump Coronary Artery Bypass Grafting. Journal of Cardiothoracic and Vascular Anesthesia, v.28, n.5, p.1211–1216, oct. 2014.
1053-0770
10.1053/j.jvca.2014.03.003
Autor
Salgado, Maria A. M
Salgado Filho, Marcelo F
Brito, José O. Reis
Lessa, Marcos A
Tibiriça, Eduardo
Resumen
Objectives: To evaluate the effectiveness of single-point
laser Doppler perfusion monitoring (LDPM) in the assessment
of microvascular reactivity in the skin during cardiopulmonary
bypass (CPB).
Design: Cross-sectional observational study.
Setting: Government-affiliated teaching hospital.
Participants: Twenty male patients aged 60 2 years
who underwent coronary artery bypass grafting under CPB.
Interventions: The authors assessed the endotheliumdependent
vasodilation of the skin microcirculation at the
forehead and forearm using LDPM coupled with thermal
hyperemia. This measurement was performed before and
after the induction of anesthesia, during and after CPB, and
24 h after the end of the surgical procedure.
Results: The basal values of microvascular flow before the
induction of anesthesia were significantly higher in the skin
of the forehead compared with that of the forearm. There
were no significant alterations in microvascular reactivity
throughout the recording periods for both recording sites, as
assessed by the vasodilation range expressed as cutaneous
vascular conductance (arbitrary perfusion units / mean arterial
pressure).
Conclusions: Using LDPM, the authors showed that the
microcirculatory bed of the skin of the forehead, which is
readily accessible during cardiac surgery, is a suitable model
for the study of microvascular reactivity and tissue perfusion
in cardiovascular surgical procedures using CPB. This technique
could, thus, be suitable for evaluating the effects of
drugs or technical procedures on tissue perfusion during
cardiac surgery under cardiopulmonary bypass.