Cardiopulmonary bypass in humans - Jejunal mucosal perfusion increases in parallel with well-maintained microvascular hematocrit

Acta Anaesthesiologica Scandinavica

Volumn 49, Issue 4, 2005, Pages 502-509

  Thoren A ^a   Nygren, A ^a   Houltz, E ^a   Ricksten, Sven Erik ^a  

^a SAHLGRENSKA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

Cardiopulmonary bypass; Intestinal mucosa; Laser Doppler flowmetry; Microcirculation

Indexed keywords

ADULT; AGED; ARTERIAL OXYGEN TENSION; ARTICLE; BLOOD FLOW VELOCITY; CARDIOPULMONARY BYPASS; CLINICAL ARTICLE; FEMALE; HEMATOCRIT; HEMODILUTION; HUMAN; INTESTINE MUCOSA; INTESTINE PERFUSION; JEJUNUM MUCOSA; LASER DOPPLER FLOWMETRY; MALE; MICROCIRCULATION; MICROVASCULATURE; MULTIPLE REGRESSION; OXYGEN SUPPLY; PRIORITY JOURNAL; SPLANCHNIC BLOOD FLOW; SURGICAL PATIENT;

AGED; AGED, 80 AND OVER; ANESTHESIA; CARBON DIOXIDE; CARDIOPULMONARY BYPASS; FEMALE; HEMATOCRIT; HEMODYNAMIC PROCESSES; HUMANS; INTESTINAL MUCOSA; JEJUNUM; LACTIC ACID; LASER-DOPPLER FLOWMETRY; MALE; MICROCIRCULATION; MIDDLE AGED; OXYGEN; OXYGEN CONSUMPTION; REGIONAL BLOOD FLOW;

EID: 16844381057     PISSN: 00015172     EISSN: None     Source Type: Journal    
DOI: 10.1111/j.1399-6576.2005.00627.x     Document Type: Article

References (41)

1. Landow L, Andersen LW. Splanchnic ischaemia and its role in multiple organ failure. Acta Anaesthesiol Scand 1994; 38: 626-39.
2. Mathie RT, Ohri SK, Batten JJ, Peters AM, Keogh BE. Hepatic blood flow during cardiopulmonary bypass operations, the effect of temperature and pulsatility. J Thorac Cardiovasc Surg 1997; 114: 292-3.
3. Hampton WW, Townsend MC, Schirmer WJ. Effective hepatic blood flow during cardiopulmonary bypass. Arch Surg 1989; 124: 458-9.
4. Gardeback M, Settergren G, Brodin LA et al. Splanchnic blood flow and oxygen uptake during cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2002; 16: 308-15.
5. Haisjackl M, Birnbaum J, Redlin M et al. Splanchnic oxygen transport and lactate metabolism during normothermic cardiopulmonary bypass in humans. Anesth Analg 1998; 86: 22-7.
6. Yamada T, Nomoto Aota S, Nishimura M, Matsuda K, Ban K. Hepatic circulation during cardiopulmonary bypass. ASAIO J 1995; 41: M294-7.
7. Berendes E, Möllhoff T, Van Aken H et al. Effects of dopexamine on creatinine clearance, systemic inflammation, and splanchnic oxygenation in patients undergoing coronary artery bypass grafting. Anesth Analg 1997; 84: 950-7.
8. Landow L. Splanchnic lactate production in cardiac surgery patients. Crit Care Med 1993; 21: S84-S91.
9. Mythen MG, Webb AR. Intra-operative gut mucosal hypoperfusion is associated with increased post-operative complications and cost. Intensive Care Med 1994; 20: 99-104.
10. Riddington DW, Venkatesh B, Boivin CM et al. Intestinal permeability, gastric intramucosal pH and systemic endotoxemia in patients undergoing cardiopulmonary bypass. JAMA 1996; 275: 1007-12.
11. Ohri SK, Bjarnason Pathi I, Somasundaram V et al. Ann Thoracic Surg 1993; 55: 1080-6.
12. Ohri SK, Bowles CW, Mathie RT, Lawrence DR, Keogh BE, Taylor KM. Effects of cardiopulmonary bypass perfusion protocols on gut tissue oxygenation and blood flow. Ann Thorac Surg 1997; 64: 163-70.
13. Sicsic JC, Duranteau J, Corbineau H et al. Gastric mucosal oxygen delivery decreases during cardiopulmonary bypass despite constant systemic oxygen delivery. Anesth Analg 1998; 86: 455-60.
14. Thorén A, Elam M, Ricksten SE. Jejunal mucosal perfusion is well maintained during mild hypothermic cardiopulmonary bypass in humans. Anesth Analg 2001; 92: 5-11.
15. Thorén A, Elam M, Ricksten SE. Differential effects of dopamine, dopexamine and dobutamine on jejunal mucosal perfusion early after cardiac surgery. Crit Care Med 2000; 28: 2338-43.
16. Thorén A, Ricksten S-E, Lundin S, Gazelius B, Elam M. Baroreceptor-mediated reduction of jejunal mucosal perfusion, evaluated with endoluminal laser Doppler flowmetry in conscious humans. J Auton Nerv Syst 1998; 68: 157-63.
17. Hudetz AG, Wood JD, Biswal BB, Krolo I, Kampine JP. Effect of haemodilution on RBC velocity, supply rate, and haematocrit in the cerebral capillary network. J Appl Physiol 1999; 87: 505-9.
18. Colantuouni A, Bertuglia S. Correlation between laser Doppler perfusion monitoring and haematocrit in hamster cheek pouch microcirculation. Int J Microcirc 1997; 17: 33-40.
19. Thollander M, Hellström PM, Svensson TH, Gazelius B. Haemodynamic changes in the small intestine correlate to migrating motor complex in humans. Eur J Gastroenterol Hepatol 1996; 8: 777-85.
20. Colantuoni A, Bertuglia S, Intaglietta M. Microvascular vasomotion: origin of laser Doppler flux motion. Int J Microcirc Clin Exp 1994; 14: 151-8.
21. Colantuoni A, Bertuglia S, Intaglietta M. The effects of alfa-or beta-adrenergic receptor agonists and antagonists and calcium entry blockers on the spontaneous vasomotion. Microvasc Res 1984; 28: 143-58.
22. Haisjackl M, Luz G, Sparr H et al. The effects of progressive anemia on jejunal mucosal and serosal tissue oxygenation in pigs. Anesth Analg 1997; 84: 538-44.
23. Ballermann BJ, Dardik A, Eng E, Liu A. Shear stress and the endothelium. Kidney Int Suppl 1998; 67: S100-8.
24. Bastien O, Piriou V, Aouifi A, Flamens C, Evans R, Lehot JJ. Relative importance of flow versus pressure in splanchnic perfusion during cardiopulmonary bypass in rabbits. Anesthesiology 2000; 92: 457-64.
25. Lipowsky HH, Firrell JC. Microvascular hemodynamics during systemic haemodilution and hemoconcentration. Am J Physiol 1986; 250: H908-22.
26. Intaglietta M. Microcirculatory effects of haemodilution: background and analysis. In: Tuma RF, White JV, Messmer K, eds. The Role of Haemodilution in Optimal Patient Care. Munchen: W. Zuckschwerdt Verlag, 1989: 21-41.
27. Tsai AG, Friesenecker B, McCarthy M, Sakai H, Intaglietta M. Plasma viscosity regulates capillary perfusion during extreme haemodilution in hamster skinfold model. Am J Physiol 1998; 275: H2170-80.
28. Tsai AG, Intaglietta M. Local tissue oxygenation during constant red blood cell flux, a discrete source analysis of velocity and haematocrit changes. Microvasc Res 1989; 37: 308-22.
29. Thorén A, Jacob SM, Pradl R, Elam M, Ricksten SE, Takala J. Jejunal and gastric mucosal perfusion vs. splanchnic blood flow and metabolism. An observational study on postcardiac surgical patients. Crit Care Med 2000; 28: 3649-54.
30. Hasibeder W, Germann R, Sparr H et al. Vasomotion induces regular major oscillations in jejunal mucosal tissue oxygenation. Am J Physiol 1994; 266: G978-G986.
31. Germann R, Haisjackl M, Hasibeder W et al. Dopamine and mucosal oxygenation in the porcine jejunum. J Appl Physiol 1994; 77: 2845-52.
32. Madorin WS, Martin CM, Sibbald WJ. Dopexamine attenuates flow motion in ileal mucosal arterioles in normotensive sepsis. Crit Care Med 1999; 27: 394-400.
33. Intaglietta M, Arteriolar Vasomotion. Implications for tissue ischaemia. Blood Vessels 1991; 28: 1-7.
34. Haisjackl M, Germann R, Hasibeder W et al. Mucosal tissue oxygenation of the porcine jejunum during normothermic cardiopulmonary bypass. Br J Anaesth 1999; 82: 738-45.
35. Gustafsson H. Vasomotion and underlying mechanisms in small arteries: An in vitro study of rat blood vessels. Acta Physiol Scand 1993; 149 (Suppl. 614): 611.
36. Funk W, Endrich B, Messmer K, Intaglietta M. Spontaneous arteriolar vasomotion as a determinant of peripheral vascular resistance. Int J Microcirc: Clin Exp 1983; 2: 11-25.
37. Gustafsson U, Wardell K, Nilsson GE, Lewis DH. Vasomotion in rat skeletal muscle induced by hemorrhage as recorded by laser-Doppler flowmetry. Microvasc Res 1991; 42: 224-8.
38. Bertuglia S, Colantuoni A, Coppini G, Intaglietta M. Hypoxia- or hyperoxia-induced changes in arteriolar vasomotion in skeletal muscle microcirculation. Am J Physiol 1991; 260: H362-H372.
39. Ahn H, Lindhagen J, Nilsson GE et al. Assessment of blood flow in the small intestine with laser Doppler flowmetry. Scand J Gastroenterol 1986; 21 (7): 863-70.
40. Ahn H, Lindhagen J, Nilsson GE et al. Evaluation of laser Doppler flowmetry in the assessment of intestinal blood flow in cat. Gastroenterology 1985; 88 (4): 951-7.
41. Kvietys PRAP, Shepherd DN, Granger DN. Laser-Doppler, H2 clearance, and microsphere estimates of mucosal blood flow. Am J Physiol 1985; 249: 2 Part 1: G221-7.