Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass
Obesity is a frequent comorbidity among patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Cardiac surgery with CPB impairs microcirculatory perfusion, which is associated with multiple organ failure. As microvascular function is frequently compromised in obese patients, we studi...
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doaj-57af9dc6ed614d3dbbf9f8bf016da8f52021-01-27T00:04:59ZengMDPI AGJournal of Clinical Medicine2077-03832021-01-011046946910.3390/jcm10030469Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary BypassChantal A. Boly0Margot Venhuizen1Nicole A. M. Dekker2Alexander B. A. Vonk3Christa Boer4Charissa E. van den Brom5Department of Anesthesiology, Amsterdam UMC, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Cardiothoracic Surgery, Amsterdam UMC, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC, VU University, 1081 HV Amsterdam, The NetherlandsDepartment of Anesthesiology, Amsterdam UMC, VU University, 1081 HV Amsterdam, The NetherlandsObesity is a frequent comorbidity among patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Cardiac surgery with CPB impairs microcirculatory perfusion, which is associated with multiple organ failure. As microvascular function is frequently compromised in obese patients, we studied whether cardiac surgery with CPB has a more detrimental effect on microcirculatory perfusion in obese patients. Sublingual microcirculatory perfusion was measured with sidestream dark field (SDF) imaging in obese patients (body mass index ≥32 kg/m<sup>2</sup>; <i>n</i> = 14) without type II diabetes mellitus and in lean patients (BMI 20–25 kg/m<sup>2</sup>; <i>n</i> = 22) undergoing cardiac surgery with CPB. CPB reduced systolic blood pressure and mean arterial pressure more profoundly in lean compared with obese patients (SBP: 38% vs. 18%; MAP: 11% vs. 8%, <i>p</i> < 0.05), and both restored after weaning from CPB. No differences were present in intraoperative glucose, hematocrit, hemoglobin, lactate, and blood gas values between obese and lean patients. Microcirculatory perfusion did not differ between obese and lean patients the day before surgery. CPB decreased microcirculatory perfusion with 9% in both groups, but this was only significant in lean patients (<i>p</i> < 0.05). Three days following surgery, microcirculatory perfusion was restored in both groups. In conclusion, microcirculatory perfusion was equally disturbed during cardiac surgery with CPB in metabolically healthy obese patients compared to lean patients.https://www.mdpi.com/2077-0383/10/3/469cardiac surgerycardiopulmonary bypassmicrocirculationobesitySDFperfusion |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Chantal A. Boly Margot Venhuizen Nicole A. M. Dekker Alexander B. A. Vonk Christa Boer Charissa E. van den Brom |
spellingShingle |
Chantal A. Boly Margot Venhuizen Nicole A. M. Dekker Alexander B. A. Vonk Christa Boer Charissa E. van den Brom Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass Journal of Clinical Medicine cardiac surgery cardiopulmonary bypass microcirculation obesity SDF perfusion |
author_facet |
Chantal A. Boly Margot Venhuizen Nicole A. M. Dekker Alexander B. A. Vonk Christa Boer Charissa E. van den Brom |
author_sort |
Chantal A. Boly |
title |
Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass |
title_short |
Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass |
title_full |
Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass |
title_fullStr |
Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass |
title_full_unstemmed |
Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass |
title_sort |
comparison of microcirculatory perfusion in obese and non-obese patients undergoing cardiac surgery with cardiopulmonary bypass |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-01-01 |
description |
Obesity is a frequent comorbidity among patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Cardiac surgery with CPB impairs microcirculatory perfusion, which is associated with multiple organ failure. As microvascular function is frequently compromised in obese patients, we studied whether cardiac surgery with CPB has a more detrimental effect on microcirculatory perfusion in obese patients. Sublingual microcirculatory perfusion was measured with sidestream dark field (SDF) imaging in obese patients (body mass index ≥32 kg/m<sup>2</sup>; <i>n</i> = 14) without type II diabetes mellitus and in lean patients (BMI 20–25 kg/m<sup>2</sup>; <i>n</i> = 22) undergoing cardiac surgery with CPB. CPB reduced systolic blood pressure and mean arterial pressure more profoundly in lean compared with obese patients (SBP: 38% vs. 18%; MAP: 11% vs. 8%, <i>p</i> < 0.05), and both restored after weaning from CPB. No differences were present in intraoperative glucose, hematocrit, hemoglobin, lactate, and blood gas values between obese and lean patients. Microcirculatory perfusion did not differ between obese and lean patients the day before surgery. CPB decreased microcirculatory perfusion with 9% in both groups, but this was only significant in lean patients (<i>p</i> < 0.05). Three days following surgery, microcirculatory perfusion was restored in both groups. In conclusion, microcirculatory perfusion was equally disturbed during cardiac surgery with CPB in metabolically healthy obese patients compared to lean patients. |
topic |
cardiac surgery cardiopulmonary bypass microcirculation obesity SDF perfusion |
url |
https://www.mdpi.com/2077-0383/10/3/469 |
work_keys_str_mv |
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