Anesthesia and the microcirculation

Seminars in Cardiothoracic and Vascular Anesthesia

Volumn 13, Issue 4, 2009, Pages 249-258

  Turek, Zdenek ^a   Sykora, Roman ^b,c   Matejovic, Martin ^b,d   Cerny, Vladimir ^a  

^a UNIVERSITY HOSPITAL HRADEC KRALOVE   (Czech Republic)

^b CHARLES UNIVERSITY   (Czech Republic)

^c Hospital Karlovy Vary   (Czech Republic)

^d University Affiliated Hospital Plzen   (Czech Republic)

Author keywords

Anesthetic agents; Fluid therapy; Microcirculation; Organ perfusion

Indexed keywords

BUPRENORPHINE; CYTOKINE; DESFLURANE; ETOMIDATE; FENTANYL; HALOTHANE; INHALATION ANESTHETIC AGENT; INTRAVENOUS ANESTHETIC AGENT; ISOFLURANE; KETAMINE; MIDAZOLAM; NITRIC OXIDE; PROPOFOL; PROSTAGLANDIN DERIVATIVE; SEVOFLURANE; THIOPENTAL;

ANESTHESIA LEVEL; ANTIINFLAMMATORY ACTIVITY; BLOOD VESSEL REACTIVITY; CARDIOPULMONARY BYPASS; CORONARY ARTERY BLOOD FLOW; DOSE RESPONSE; DRUG MECHANISM; EPIDURAL ANESTHESIA; FLUID THERAPY; GOAL ATTAINMENT; HEMORRHAGIC SHOCK; HUMAN; INHALATION ANESTHESIA; INTRAVENOUS ANESTHESIA; ISCHEMIC PRECONDITIONING; KIDNEY BLOOD FLOW; LASER DOPPLER FLOWMETRY; MEAN ARTERIAL PRESSURE; MICROCIRCULATION; NONHUMAN; ORGAN PERFUSION; PATHOPHYSIOLOGY; PERIOPERATIVE PERIOD; POSTOPERATIVE COMPLICATION; REVIEW; SEPSIS; SPLANCHNIC BLOOD FLOW; SYSTEMIC VASCULAR RESISTANCE; TISSUE PERFUSION;

ANESTHESIA; ANESTHESIA, EPIDURAL; ANESTHETICS, INHALATION; ANESTHETICS, INTRAVENOUS; ANIMALS; CARDIOPULMONARY BYPASS; DOGS; FLUID THERAPY; HUMANS; MICROCIRCULATION; MONITORING, INTRAOPERATIVE; REPERFUSION;

EID: 73849095076     PISSN: 10892532     EISSN: None     Source Type: Journal    
DOI: 10.1177/1089253209353134     Document Type: Review

References (112)

1. Tooke JE Microvasculature in diabetes. Cardiovasc Res. 1996 ; 32: 764-771.
2. Lehr HA, Bittinger F., Kirkpatrick CJ Microcirculatory dysfunction in sepsis: a pathogenetic basis for therapy ? J Pathol. 2000 ; 190: 373-386.
3. Groner W., Winkelman JW, Harris AG, et al. Orthogonal polarization spectral imaging: a new method for study of the microcirculation. Nat Med. 1999 ; 5: 1209-1212.
4. Ince C. Sidestream dark-field (SDF) imaging: an improved technique to observe sublingual microcirculation. Crit Care. 2005 ; 8 (suppl 1). P72
5. Ince C. The microcirculation is the motor of sepsis. Crit Care. 2005 ; 9 (suppl 4). S13 - S19.
6. Goedhart PT, Khalilzada M., Bezemer R., Merza J., Ince C. Sidestream dark field (SDF) imaging: a novel stroboscopic LED ring-based imaging modality for clinical assessment of the microcirculation. Opt Express. 2007 ; 15: 15101-15114.
7. Cerny V., Turek Z., Parizkova R. Orthogonal polarization spectral imaging. Physiol Res. 2007 ; 56: 141-147.
8. De Backer D. OPS techniques. Minerva Anestesiol. 2003 ; 69: 388-391.
9. Oberg PA Laser-Doppler flowmetry. Crit Rev Biomed Eng. 1990 ; 18: 125-163.
10. Humeau A., Steenbergen W., Nilsson H., Strmberg T. Laser Doppler perfusion monitoring and imaging: novel approaches. Med Biol Eng Comput. 2007 ; 45: 421-435. (Pubitemid 46681616)
11. Obeid AN, Barnett NJ, Dougherty G., Ward G. A critical review of laser Doppler flowmetry. J Med Eng Technol. 1990 ; 14: 178-181.
12. Neviere R., Mathieu D., Chagnon JL, Lebleu N., Millien JP, Wattel F. Skeletal muscle microvascular blood flow and oxygen transport in patients with severe sepsis. Am J Respir Crit Care Med. 1996 ; 153: 191-195.
13. Neviere R., Mathieu D., Chagnon JL, Lebleu N., Wattel F. The contrasting effects of dobutamine and dopamine on gastric mucosal perfusion in septic patients. Am J Respir Crit Care Med. 1996 ; 154: 1684-1688.
14. Ebert TJ, Kanitz DD, Kampine JP Inhibition of sympathetic neural outflow during thiopental anesthesia in humans. Anesth Analg. 1990 ; 71: 319-326.
15. Krassioukov AV, Gelb AW, Weaver LC Actions of propofol on central sympathetic mechanisms controlling blood pressure. Can J Anaesth. 1993 ; 40: 761-769.
16. Ivankovich AD, Miletich DJ, Reimann C., Albreich RF, Zahad B. Cardiovascular effects of centrally administered ketamine in goats. Anesth Analg. 1974 ; 53: 924-933.
17. Bilotta F., Fiorani L., La RI, Spinelli F., Rosa G. Cardiovascular effects of intravenous propofol administered at two infusion rates: a transthoracic echocardiographic study. Anaesthesia. 2001 ; 56: 266-271.
18. Sprung J., Ogletree-Hughes ML, McConnell BK, Zakhary DR, Smolsky SM, Moravec CS The effects of propofol on the contractility of failing and nonfailing human heart muscles. Anesth Analg. 2001 ; 93: 550-559.
19. Kurokawa H., Murray PA, Damron DS Propofol attenuates beta-adrenoreceptor-mediated signal transduction via a protein kinase C-dependent pathway in cardiomyocytes. Anesthesiology. 2002 ; 96: 688-698.
20. Holzmann A., Schmidt H., Gebhardt MM, Martin E. Propofol-induced alterations in the microcirculation of hamster striated muscle. Br J Anaesth. 1995 ; 75: 452-456.
21. Longnecker DE, Miller FN, Harris DE Small artery and vein response to ketamine HCl in the bat wing. Anesth Analg. 1974 ; 53: 64-68.
22. Wada DR, Harashima H., Ebling WF, Osaki EW, Stanski DR Effects of thiopental on regional blood flows in the rat. Anesthesiology. 1996 ; 84: 596-604.
23. Hirota K., Lambert DG I.V. anaesthetic agents inhibit dihydropyridine binding to L-type voltage sensitive Ca2+ channels in rat cerebrocortical membranes. Br J Anaesth. 1996 ; 77: 248-253.
24. Bazin JE, Dureuil B., Danialou G., Vicaut E., Aubier M., Desmonts JM, Boczkowski J. Effects of etomidate, propofol and thiopental anaesthesia on arteriolar tone in rat diaphragm. Br J Anaesth. 1998 ; 81: 430-435.
25. Kurosawa S., Kato M. Anesthetics, immune cells, and immune response. J Anesth. 2008 ; 22: 263-277.
26. Hamburger JA, Meiler SE Anesthesia drugs, immunity, and long-term outcome. Curr Opin Anaesthesiol. 2006 ; 19: 423-428.
27. Vasileiou I., Xanthos T., Koudouna E., et al. Propofol: a review of its non-anaesthetic effects. Eur J Pharmacol. 2009 ; 605: 1-8.
28. Leaphart CL, Tepas JJ The gut is a motor of organ system dysfunction. Surgery. 2007 ; 141: 563-569.
29. Nieuwenhuijzen GA, Goris RJ The gut: the motor of multiple organ dysfunction syndrome ? Curr Opin Clin Nutr Metab Care. 1999 ; 2: 399-404.
30. Brookes ZL, Brown NJ, Reilly CS Differential effects of intravenous anaesthetic agents on the response of rat mesenteric microcirculation in vivo after haemorrhage. Br J Anaesth. 2002 ; 88: 255-263.
31. Christiansen CL, Ahlburg P., Jacobsen CJ, Andresen EB, Paulsen PK The influence of propofol and midazolame/ halothane anesthesia on hepatic SvO2 and gastric mucosal pH during cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1998 ; 12: 418-421.
32. Gonzalez-Correa JA, Cruz-Andreotti E., Arrebola MM, Lopez-Villodres JA, Jodar M., De La Cruz JP Effects of propofol on the leukocyte nitric oxide pathway: in vitro and ex vivo studies in surgical patients. Naunyn Schmiedebergs Arch Pharmacol. 2008 ; 376: 331-339.
33. Gilliland HE, Armstrong MA, Carabine U., McMurray TJ The choice of anesthetic maintenance technique influences the antiinflammatory cytokine response to abdominal surgery. Anesth Analg. 1997 ; 85: 1394-1398.
34. Laffey JG, Boylan JF, Cheby DC The systemic inflammatory response to cardiac surgery: implication for the anesthesiologist. Anesthesiology. 2002 ; 97: 215-252.
35. Piriou V., Chiari P., Lehot JJ, Foex P., Arvieux CC Effects of propofol on haemodynamics and on regional blood flows in dogs submitted or not to a volaemic expansion. Eur J Anaesthesiol. 1999 ; 16: 615-621.
36. Koch M., Be Baker D., Vincent JL, Barvais L., Hennart D., Schmartz D. Effects of propofol on human microcirculation. Br J Anaesth. 2008 ; 101: 473-478.
37. Weiskopf RB, Calahan MK, Eger EI, et al. Cardiovascular actions of desflurane in normocarbic volunteers. Anesth Analg. 1991 ; 73: 143-156.
38. Stevens WC, Cromwell TH, Halsey MJ, Eger EI, Shakespeare TF, Bahlman SH The cardiovascular effects of a new inhalation anesthetic, Forane, in human volunteers at constant arterial carbon dioxide tension. Anesthesiology. 1971 ; 35: 8-16.
39. Kazama T., Ikeda K. The comparative cardiovascular effects of sevoflurane with halothane and isoflurane. J Anesth. 1988 ; 2: 63-68.
40. Malan TP Jr, DiNardo JA, Isner RJ, et al. Cardiovascular effects of sevoflurane compared with those of isoflurane in volunteers. Anesthesiology. 1995 ; 83: 918-928.
41. Eger EI, Smith NT, Stoelting RK, Culen DJ, Kadis LB, Whitcher CE Cardiovascular effects of halothane in man. Anesthesiology. 1970 ; 32: 396-409.
42. Elbers PW, Ince C. Bench-to-bedside review: mechanisms of critical illness-classifying microcirculatory flow abnormalities in distributive shock. Crit Care. 2006 ; 10: 221.
43. OĝRiordan J., OĝBeirne HA, Yang Y., Bellamy MC Effects of desflurane and isoflurane on splanchnic microcirculation during major surgery. Br J Anaesth. 1997 ; 78: 95-96.
44. Hartman JC, Pagel PS, Proctor LT, Kampine JP, Schmeling WT, Warltier DC Influence of desflurane, isoflurane and halothane on regional tissue perfusion in dogs. Can J Anaesth. 1992 ; 39: 877-887.
45. Merin RG, Bernard JM, Doursout MF, Cohen M., Chelly J. Comparison of the effects of isoflurane and desflurane on cardiovascular dynamics and regional blood flow in the chronically instrumented dog. Anesthesiology. 1991 ; 74: 568-574.
46. Bernard JM, Doursout MF, Wouters P., Hartley CJ, Merin RG, Chelly JE Effects of sevoflurane and isoflurane on hepatic circulation in the chronically instrumented dog. Anesthesiology. 1992 ; 77: 541-545.
47. Manohar M., Parks CM Porcine systemic and regional organ blood flow during 1.0 and 1.5 minimum alveolar concentration of sevoflurane anesthesia without and with 50% nitrous oxide. J Pharmacol Exp Ther. 1984 ; 231: 640-648.
48. Sundeman H., Biber B., Raner C., Winso O. Autoregulation and vasodilator response by isoflurane and desflurane in the feline renal vascular bed. Acta Anaesthesiol Scand. 1997 ; 41: 1180-1186.
49. Hartman JC, Pagel PS, Kampine JP, Schmeling WT, Warltier DC Influence of desflurane on regional distribution of coronary blood flow in a chronically instrumented canine model of multivessel coronary artery obstruction. Anesth Analg. 1991 ; 72: 289-299.
50. Kersten JR, Schmeling T., Tessmer J., Hettrick DA, Pagel PS, Warltier DC Sevoflurane selectively increases coronary collateral blood flow independent of KATP channels in vivo. Anesthesiology. 1999 ; 90: 246-256.
51. Bernard JM, Wouters PF, Doursout MF, Florence B., Chelly JE, Merin RG Effects of sevoflurane and isoflurane on cardiac and coronary dynamics in chronically instrumented dogs. Anesthesiology. 1990 ; 72: 659-662.
52. Kersten JR, Orth KG, Pagel PS, Mei DA, Gross GJ, Warltier DC Role of adenosine in isoflurane-induced cardioprotection. Anesthesiology. 1997 ; 86: 1128-1139.
53. Novalija E., Fujita S., Kampine JP, Stowe DF Sefoflurane mimics ischemic preconditioning effects on coronary flow and nitric oxide release in isolated hearts. Anesthesiology. 1999 ; 91: 701-712.
54. Toller WG, Kersten JR, Pagel PS, Hettrick DA, Warltier DC Sevoflurane reduces myocardial infarct size and decreases the time threshold for ischemic preconditioning in dogs. Anesthesiology. 1999 ; 91: 1437-1446.
55. Toller WG, Gross ER, Kersten JR, Pagel PS, Gross GJ, Warltier DC Sarcolemmal and mitochondrial adenosine triphosphate-dependent potassium channels: mechanisms of desflurane-induced cardioprotection. Anesthesiology. 2000 ; 92: 1731-1739.
56. Mitsuhata H., Shimizu R., Yokoyama MM Suppressive effects of volatile anesthetics on cytokine release in human peripheral blood mononuclear cells. Int J Immunopharmacol. 1995 ; 17: 529-534.
57. Nakamura T., Kashimoto S., Oguchi T., Kumazawa T. Hydroxyl radical formation during inhalation anesthesia in the reperfused working rat heart. Can J Anaesth. 1999 ; 46: 470-475.
58. Kowalski C., Zahler S., Becker BF, et al. Halothane, isoflurane, and sevoflurane reduce postischemic adhesion of neutrophils in the coronary system. Anesthesiology. 1997 ; 86: 188-195.
59. Miyawaki I., Nakamura K., Terasako K., Toda H., Kakuyama M., Mori K. Modification of endothelium-dependent relaxation by propofol, ketamine, and midazolam. Anesth Analg. 1995 ; 81: 474-479.
60. Englehart MS, Allison CE, Tieu BH, et al. Ketamine-based total intravenous anesthesia versus isoflurane anesthesia in a swine model of hemorrhagic shock. J Trauma. 2008 ; 65: 901-908.
61. Samarska IV, van Meurs M., Buikema H., et al. Adjunct nitrous oxide normalizes vascular reactivity changes after hemorrhage shock in mice under isoflurane anesthesia. Anesthesiology. 2009 ; 111: 600-608.
62. Tsao CM, Wu CC, Wang JJ, Wong CS, Tsai SK, Ho ST Intravenous anesthetics in sepsis. Acta Anaesthesiol Taiwan. 2005 ; 43: 153-163.
63. Liu YC, Chan JY, Tsai YC Influence of propofol on blood pressure spectrum in sepsis and the role of inducible nitric oxide synthase. Acta Anaesthesiol Taiwan. 2009 ; 47: 62-70.
64. Sanders RD, Hussel T., Maze M. Sedation and immunomodulation. Crit Care Clin. 2009 ; 25: 551-570.
65. Clemente A., Carli F. The physiological effects of thoracic epidural anesthesia and analgesia on the cardiovascular, respiratory and gastrointestinal system. Minerva Anestesiol. 2008 ; 74: 549-563.
66. Wattwil M., Sundberg A., Arvill A., Lennquist C. Circulatory changes during high thoracic epidural anaesthesia-influence of sympathetic block and of systemic effect of the local anaesthetic. Acta Anaesthesiol Scand. 1985 ; 29: 849-855.
67. Loick HM, Schmidt C., Van Aken H., Junker R., Erren M., Berendes E. High thoracic epidural anesthesia, but not clonidine, attenuates the perioperative stress response via sypmpatholysis and reduces the release of troponin T in patients undergoing coronary artery bypass grafting. Anesth Analg. 1999 ; 88: 701-709.
68. Stanton-Hicks MA Cardiovascular effects of extradural anaesthesia. Br J Anaesth. 1975 ; 47 (suppl): 253-261.
69. Klassen GA, Bramwell RS, Bromage PR, Zborowska-Sluis DT Effect of acute sympathectomy by epidural anesthesia on the canine coronary circulation. Anesthesiology. 1980 ; 52: 8-15.
70. Davis RF, DeBoer LW, Maroko PR Thoracic epidural anesthesia reduces myocardial infarct size after coronary artery occlusion in dogs. Anesth Analg. 1986 ; 65: 711-717.
71. Hogan QH, Stadnicka A., Kampine JP Effect of epidural anesthesia on splanchnic capacitance. Adv Pharmacol. 1994 ; 31: 471-483.
72. Hogan QH, Stekiel TA, Stadnicka A., Bosnjak ZJ, Kampine JP Region of epidural blockade determinates sympathetic and mesenteric capacitance effects in rabbits. Anesthesiology. 1995 ; 83: 604-610.
73. Lazar G., Kazsaki J., Abraham S., et al. Thoracic epidural anesthesia improves the gastric microcirculation during experimental gastric tube formation. Surgery. 2003 ; 134: 799-805.
74. Sielenkamper AW, Eicker K., Van Aken H. Thoracic epidural anesthesia increases mucosal perfusion in ileum of rats. Anesthesiology. 2000 ; 93: 844-851.
75. Gould TH, Grace K., Thorne G., Thomas M. Effect of thoracic epidural anesthesia on colonic blood flow. Br J Anaesth. 2002 ; 89: 446-451.
76. Hahnenkamp K., Theilmeier G., Van Aken HK, Heonemann CW The effects of local anesthetics on perioperative coagulation, inflammation and microcirculation. Anesth Analg. 2002 ; 94: 1441-1447.
77. Martinez-Pelus AE, Merino P., Bru M., et al. Endogenous endotoxemia of intestinal origin during cardiopulmonary bypass. Intensive Care Med. 1997 ; 23: 1251-1257.
78. Takahashi T., Kunimoto F., Ichikawa H., et al. Gastric mucosal pH and hepatic venous oximetry after cardiopulmonary bypass. Intensive Care Med. 1997 ; 23: 1251-1257.
79. Gardeback M., Settergren G., Brodin LA, et al. Splanchnic blood flow and oxygen uptake during cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 2002 ; 16: 308-315.
80. Hampton WW, Townsend MC, Schirmer WJ, Haybron DM, Fry DE Effective hepatic blood flow during cardiopulmonary bypass. Arch Surg 1989 ; 124: 458-459.
81. Haisjackl M., Birnbaum J., Redlin M., et al. Splanchnic oxygen transport and lactate metabolism during normothermic cardiopulmonary bypass in humans. Anesth Analg. 1998 ; 86: 22-27.
82. Bauer A., Kofler S., Thiel M., Eifert S., Christ F. Monitoring of the sublingual microcirculation in cardiac surgery using orthogonal polarization spectral imaging: preliminary results. Anesthesiology. 2007 ; 107: 939-945.
83. Suleiman MS, Zacharowski K., Angelini GD Inflammatory response and cardioprotection during open-heart surgery: the importance of anaesthetics. Br J Pharmacol. 2008 ; 153: 21-33.
84. Kurz A., Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization: study of wound infection and temperature group. N Engl J Med 1996 ; 334: 1209-1215.
85. Greif R., Akca O., Horn EP, Kurz A., Sessler DI Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection: Outcomes Research Group. N Engl J Med. 2000 ; 342: 161-167.
86. Belda FJ, Aguilera L., Garcia de la AJ, et al. Supplemental perioperative oxygen and the risk of surgical wound infection: a randomized controlled trial. JAMA. 2005 ; 294: 2035-2042.
87. Grocott MP, Mythen MG, Gan TJ Perioperative fluid management and clinical outcomes in adults. Anesth Analg. 2005 ; 100: 1093-1106.
88. Holte K., Kehlet H. Fluid therapy and surgical outcomes in elective surgery: a need for reassessment in fast-track surgery. J Am Coll Surg. 2006 ; 202: 971-989.
89. Chappell D., Jacob M., Hofmann-Kiefer K., Conzen P., Rehm M. A rational approach to perioperative fluid management. Anesthesiology. 2008 ; 109: 723-740.
90. Tote SP, Grounds RM Performing perioperative optimization of the high-risk surgical patient. Br J Anaesth. 2006 ; 97: 4-11.
91. Bundgaard-Nielsen M., Secher NH, Kehlet H. ĝžLiberal" vs. "restrictive" perioperative fluid therapy: a critical assessment of the evidence. Acta Anaesthesiol Scand. 2009 ; 53: 843-851.
92. Funk DJ, Moretti EW, Gan TJ Minimally invasive cardiac output monitoring in the perioperative setting. Anesth Analg. 2009 ; 108: 887-897.
93. Ali SZ, Bracht H., Krejci V., et al. The immediate and sustained effects of volume challenge on regional blood flows in pigs. Anesth Analg. 2008 ; 106: 595-600.
94. Mythen MG, Webb AR The role of gut mucosal hypoperfusion in the pathogenesis of post-operative organ dysfunction. Intensive Care Med. 1994 ; 20: 203-209.
95. Humeau A., Steenbergen W., Nilsson H., Stromberg T. Laser Doppler perfusion monitoring and imaging: novel approaches. Med Biol Eng Comput. 2007 ; 45: 421-435. (Pubitemid 46681616)
96. de Backer D., Creteur J., Preiser JC, Dubois MJ, Vincent JL Microvascular blood flow is altered in patients with sepsis. Am J Respir Crit Care Med. 2002 ; 166: 98-104.
97. de Backer D., Creteur J., Dubois MJ, Sakr Y., Vincent JL Microvascular alterations in patients with acute severe heart failure and cardiogenic shock. Am Heart J. 2004 ; 147: 91-99.
98. Tugtekin IF, Radermacher P., Theisen M., et al. Increased ileal-mucosal-arterial PCO2 gap is associated with impaired villus microcirculation in endotoxic pigs. Intensive Care Med. 2001 ; 27: 757-766.
99. Sykora R., Chvojka J., Krouzecky A., et al. Coupled plasma filtration adsorption in experimental peritonitis-induced septic shock. Shock. 2009 ; 31: 473-480.
100. 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.
101. Pargger H., Hampl KF, Christen P., Staender S., Scheidegger D. Gastric intramucosal pH-guided therapy in patients after elective repair of infrarenal abdominal aneurysms: is it beneficial ? Intensive Care Med. 1998 ; 24: 769-776.
102. Ivatury RR, Simon RJ, Islam S., Fueg A., Rohman M., Stahl WM A prospective randomized study of end points of resuscitation after major trauma: global oxygen transport indices versus organ-specific gastric mucosal pH. J Am Coll Surg. 1996 ; 183: 145-154.
103. Mythen MG, Webb AR Perioperative plasma volume expansion reduces the incidence of gut mucosal hypoperfusion during cardiac surgery. Arch Surg. 1995 ; 130: 423-429.
104. Theodoropoulos G., Lloyd LR, Cousins G., Pieper D. Intraoperative and early postoperative gastric intramucosal pH predicts morbidity and mortality after major abdominal surgery. Am Surg. 2001 ; 67: 303-308.
105. Brinkmann A., Calzia E., TrCurrency signger K., Radermacher P. Monitoring the hepato-splanchnic region in the critically ill patient: measurement techniques and clinical relevance. Intensive Care Med. 1998 ; 24: 542-556.
106. Choileain NN, Redmond PH Cell response to surgery. Arch Surg. 2006 ; 141: 1132-1140.
107. Miyazaki T., Kuwano H., Kato H., Yoshikawa M., Ojima H., Tsukada K. Predictive value of blood flow in the gastric tube in anastomotic insufficiency after thoracic esophagectomy. World J Surg. 2002 ; 26: 1319-1323.
108. Vignali A., Gianotti L., Braga M., Radaelli G., Malvezzi L., Di Carlo V. Altered microperfusion at the rectal stump is predictive for rectal anastomotic leak. Dis Colon Rectum. 2000 ; 43: 76-82.
109. Jhanji S., Lee C., Watson D., Hinds C., Pearse RM Microvascular flow and tissue oxygenation after major abdominal surgery: association with post-operative complications. Intensive Care Med. 2009 ; 35: 671-677.
110. Hiltebrand LB, Kimberger O., Arnberger M., Brandt S., Kurz A., Sigurdsson GH Crystalloids versus colloids for goal-directed fluid therapy in major surgery. Crit Care. 2009 ; 13: R40.
111. Kimberger O., Arnberger M., Brandt S., et al. Goal-directed colloid administration improves the microcirculation of healthy and perianastomotic colon. Anesthesiology. 2009 ; 110: 496-504.
112. Trzeciak S., McCoy JV, Phillip Dellinger R., et al. Microcirculatory Alterations in Resuscitation and Shock (MARS) investigators: early increases in microcirculatory perfusion during protocol-directed resuscitation are associated with reduced multi-organ failure at 24 h in patients with sepsis. Intensive Care Med. 2008 ; 34: 2210-2217.