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Tissue near infra red spectroscopy change is not correlated with patients' outcome in elective cardiac surgery
Author(s) -
MOREL J.,
BOUCHET J. B.,
VOLA M.,
BÉRAUD A. M.,
CLERC M.,
AWAD S.,
AUBOYER C.,
MOLLIEX S.
Publication year - 2014
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12329
Subject(s) - medicine , microcirculation , cardiac surgery , organ dysfunction , cardiopulmonary bypass , intensive care unit , sofa score , prospective cohort study , cardiology , anesthesia , intensive care , surgery , intensive care medicine , sepsis
Background Microcirculatory disturbances following cardiac surgery with cardiopulmonary bypass ( CPB ) are thought to be at the origin of organ dysfunction, although few studies have correlated microvascular alterations with outcome. We aimed to assess the microcirculation with near infrared spectroscopy ( NIRS ) and correlate NIRS parameters with intensive care length of stay and organ dysfunction. Methods Forty patients at increased risk of postoperative systemic inflammatory response syndrome after an elective cardiac surgery with CPB were included in this prospective observational study. Microcirculation of the thenar eminence was analysed by NIRS technology, through the tissue oxygen saturation ( StO 2 ) and the recovery slope after an ischaemic challenge. Organ dysfunction was assessed with the S equential O rgan F ailure A ssessment ( SOFA ) score. Microcirculation parameters were recorded at baseline, at different time points during the surgery and the first 48 postoperative hours. Results StO 2 at baseline was 82% and decreased significantly until 77% at 2 h after CPB . Recovery slope values were 4.3% per second at baseline and decreased to 2.5% per second during CPB ( P < 0.05). From 12 h after CPB time point, both parameters were not statistically different from baseline anymore. We found no correlation between microcirculatory parameters and mean arterial pressure, cardiac index, intensive care unit ( ICU ) length of stay or SOFA score. Conclusion This study confirms, through a non‐invasive technology, a significant but transient alteration of the microcirculation during elective cardiac surgery. However, as these microvascular alterations were not correlated with patient's outcome, NIRS ‐derived parameters seem to be of limited interest in the cardiac surgery setting.