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Microcirculatory Perfusion During Different Perioperative Hemodynamic Strategies
Author(s) -
Stens Jurre,
Wolf Steven P.,
Zwan René J.,
Koning Nick J.,
Dekker Nicole A.M.,
Hering Jens P.,
Boer Christa
Publication year - 2015
Publication title -
microcirculation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.793
H-Index - 83
eISSN - 1549-8719
pISSN - 1073-9688
DOI - 10.1111/micc.12194
Subject(s) - perfusion , medicine , hemodynamics , mean arterial pressure , perioperative , anesthesia , abdominal surgery , blood pressure , nuclear medicine , cardiology , heart rate
Abstract Objective We investigated whether hemodynamic optimization of systemic tissue perfusion based on PPV and CI improves microcirculatory perfusion when compared to a MAP ‐based strategy in patients undergoing elective abdominal surgery. Methods Patients were randomized into a PPV / CI guided group ( n = 13, target PPV <12%, CI >2.5 L/min/m 2 , and MAP >70 mmHg) or MAP ‐guided group ( n = 18, target MAP >70 mmHg). PPV , CI , and MAP were measured using noninvasive arterial blood pressure measurements. Sublingual microcirculatory perfusion was measured at one, two, and three hours following anesthesia induction, and quantified as TVD , PVD or the proportion of perfused vessels. Data were analyzed using ANOVA RM . Results Patients in the PPV / CI group required more fluid administration than control patients (1927 ± 747 mL versus 1283 ± 582 mL, respectively; p = 0.01). Despite this difference, we observed similar values for TVD ( RM ; F (1.28) = 0.01; p = 0.92), PVD ( RM ; F (1.28) = 0.09; p = 0.77) and the proportion of perfused vessels ( RM ; F (1.28) = 0.01; p = 0.76) in both groups. Conclusion Hemodynamic optimization of systemic tissue perfusion is not associated with improvement of microcirculatory perfusion compared to a MAP ‐guided protocol in patients undergoing abdominal surgery.