体外循环期间平均动脉压对舌下微循环的影响——一项随机临床试验的次要结果
Impact of mean arterial pressure on sublingual microcirculation during cardiopulmonary bypass-Secondary outcome from a randomized clinical trial.
作者信息
Holmgaard Frederik, Vedel Anne G, Ravn Hanne Berg, Nilsson Jens C, Rasmussen Lars S
机构信息
Department of Cardiothoracic Anesthesia, Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Department of Anesthesia, Centre of Head and Orthopedics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
出版信息
Microcirculation. 2018 Jul;25(5):e12459. doi: 10.1111/micc.12459. Epub 2018 Jun 2.
OBJECTIVE
In this substudy of a randomized, clinical trial, we explored the sublingual microcirculation during cardiac surgery at 2 different levels of blood pressure. We hypothesized that a higher map during CPB would cause higher MFI.
METHODS
Thirty-six cardiac surgery patients undergoing CABG were included and randomized to either low (40-50 mm Hg) or high (70-80 mm Hg) MAP during CPB. SDF video images were recorded from the sublingual mucosa. Recordings were analyzed in a blinded fashion to quantify microcirculatory variables.
RESULTS
MAP during CPB in the low target group was 45.0 mm Hg (SD: 5.3) vs 67.2 mm Hg (SD: 8.9) in the high target group. We found no significant difference between the 2 groups in MFI during CPB evaluated for AV: 2.91 vs 2.90 (P = .82). For sm AV (<20 μm), the corresponding values were 2.87 and 2.85 in the low and high target groups, respectively (P = .82).
CONCLUSIONS
We found no significant difference in sublingual microcirculatory flow expressed as MFI according to 2 different levels of MAP during CPB.
目的
在这项随机临床试验的子研究中，我们探讨了心脏手术期间两种不同血压水平下的舌下微循环情况。我们假设体外循环期间较高的平均动脉压（MAP）会导致较高的微血管血流灌注指数（MFI）。
方法
纳入36例行冠状动脉旁路移植术（CABG）的心脏手术患者，并随机分为体外循环期间低MAP组（40 - 50 mmHg）或高MAP组（70 - 80 mmHg）。从舌下黏膜记录侧流暗视野（SDF）视频图像。以盲法分析记录结果以量化微循环变量。
结果
低目标组体外循环期间的MAP为45.0 mmHg（标准差：5.3），而高目标组为67.2 mmHg（标准差：8.9）。在评估动静脉（AV）时，我们发现两组体外循环期间的MFI无显著差异：分别为2.91和2.90（P = 0.82）。对于小动脉-静脉（sm AV，<20μm），低目标组和高目标组的相应值分别为2.87和2.85（P = 0.82）。
结论
我们发现，根据体外循环期间两种不同水平的MAP，以MFI表示的舌下微循环血流无显著差异。
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