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Review
. 2019 Jun;11(Suppl 10):S1489-S1491.
doi: 10.21037/jtd.2019.02.100.

Monitoring and optimization of the microcirculation during CPB

John M Murkin  1
Affiliations
Review

Monitoring and optimization of the microcirculation during CPB

John M Murkin. J Thorac Dis. 2019 Jun.

Abstract

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.

Keywords: Cardiopulmonary bypass (CPB); microcirculation; minimally invasive extracorporeal circulation (MiECC); near-infrared reflectance spectroscopy (NIRS), tissue oximetry; non-pulsatile bypass.

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Conflict of interest statement

Conflicts of Interest: The author has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Reperfusion slope at various measurement points pre, during and after cardiopulmonary bypass (CPB) showing progressive decrease in microcirculatory vasoreactivity with duration of non-pulsatile CPB. Error bars and ± values represent 95% CI [reproduced with permission from Smith RS, Murkin JM. (11)].
See this image and copyright information in PMC

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