Open AccessMonitoring and optimization of the microcirculation during CPB
Author(s) -
John M. Murkin
Publication year - 2019
Publication title -
journal of thoracic disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.682
H-Index - 60
eISSN - 2077-6624
pISSN - 2072-1439
DOI - 10.21037/jtd.2019.02.100
Subject(s) - medicine , microcirculation , cardiopulmonary bypass , extracorporeal circulation , pulsatile flow , perfusion , cardiology , near infrared reflectance spectroscopy , extracorporeal , intensive care medicine , neuroscience , near infrared spectroscopy , biology
In this review the impact of cardiopulmonary bypass (CPB) on the microcirculation is discussed. The impact of conventional non-pulsatile perfusion is contrasted with the microcirculatory impact of pulsatile CPB which is associated with better preservation of microcirculatory function. Evidence that alterations in microcirculatory function that persist following cardiac surgery are associated with adverse clinical outcomes is reviewed. Recent studies using novel techniques employing near infrared reflectance spectroscopy (NIRS) and sublingual microscopy to explore alterations in microcirculatory function during CPB are reviewed and the implications of these observations for studies investigating minimally invasive extracorporeal circulation (MiECC) are discussed.