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Critical Care Research and Practice
Volume 2012, Article ID 654381, 9 pages
http://dx.doi.org/10.1155/2012/654381
Clinical Study

Microcirculation and Macrocirculation in Cardiac Surgical Patients

1First Critical Care Department, Evangelismos Hospital, National and Kapodistrian University of Athens, Ypsilantou 45–47, 106 75 Athens, Greece
22nd Department of Cardiac Surgery, Evangelismos Hospital, 106 75 Athens, Greece

Received 2 January 2012; Revised 8 March 2012; Accepted 27 March 2012

Academic Editor: Arnaldo Dubin

Copyright © 2012 Elli-Sophia Tripodaki et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The aim of our study was to investigate the relationship between microcirculatory alterations after open cardiac surgery, macrohemodynamics, and global indices of organ perfusion. Methods. Patients' microcirculation was assessed with near-infrared spectroscopy (NIRS) and the vascular occlusion technique (VOT). Results. 23 patients undergoing open cardiac surgery (11 male/12 female, median age 68 (range 28–82) years, EuroSCORE 6 (1–12)) were enrolled in the study. For pooled data, CI correlated with the tissue oxygen consumption rate as well as the reperfusion rate ( 𝑟 = 0 . 5 6 , 𝑃 < 0 . 0 0 1 and 𝑟 = 0 . 5 8 , 𝑃 < 0 . 0 0 1 , resp.). In addition, both total oxygen delivery (DO2, mL/min per m2) and total oxygen consumption (VO2, mL/min per m2) also correlated with the tissue oxygen consumption rate and the reperfusion rate. The tissue oxygen saturation of the thenar postoperatively correlated with the peak lactate levels during the six hour monitoring period ( 𝑟 = 0 . 5 0 , 𝑃 < 0 . 0 5 ). The tissue oxygen consumption rate (%/min) and the reperfusion rate (%/min), as derived from the VOT, were higher in survivors compared to nonsurvivors for pooled data [23 (4–54) versus 20 (8–38) 𝑃 < 0 . 0 5 ] and [424 (27–1215) versus 197 (57–632) 𝑃 < 0 . 0 1 ], respectively. Conclusion. Microcirculatory alterations after open cardiac surgery are related to macrohemodynamics and global indices of organ perfusion.