Discover how near-infrared spectroscopy is revolutionizing our understanding of microcirculatory changes in children undergoing cardiac surgery, and the pivotal role of cardiopulmonary bypass in this medical advancement.
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Assessment of microcirculatory alteration by a vascular occlusion test using near-infrared spectroscopy in pediatric cardiac surgery: effect of cardiopulmonary bypass.
Savluk et al., Expert Rev Med Devices 2024
DOI: 10.1080/17434440.2024.2306155
Study Summary:
The study investigated the impact of cardiopulmonary bypass (CPB) on the microcirculation of pediatric patients undergoing cardiac surgery. It utilized near-infrared spectroscopy (NIRS) to monitor regional oxygen saturation and performed vascular occlusion tests (VOT) at various stages of surgery on 120 pediatric patients. The VOT was conducted at five different times: before induction (T1), after induction (T2), during CPB at full flow (T3), after CPB termination (T4), and after sternum closure (T5).
Key Findings:
- The basal value of tissue oxygen saturation was significantly lowest during CPB at full flow (T3) with p < 0.01.
- Maximum and minimum tissue oxygen saturation values were also lowest at T3 (83.4% and 52.9%, respectively).
- There were significant variations in the occlusion slope and reperfusion slopes among the different measurement times, with p < 0.01.
- A progressive decrease in reperfusion slope was observed with the duration of CPB.
Significance:
This study is important as it demonstrates that microcirculatory function in pediatric patients can be noninvasively assessed during CPB using VOT with NIRS-derived variables. This could potentially help in evaluating and improving circulatory support techniques during cardiac surgery. The research contributes to the current literature by providing a method to monitor and understand microcirculatory alterations during CPB in real-time.
Research Registration:
The research project is registered at ClinicalTrials.gov with the identifier NCT06191913.