1. Association between serosal intestinal microcirculation and blood pressure during major abdominal surgery
- Author
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Mat van Iterson, Peter G. Noordzij, Anton Fj de Bruin, Matthias P Hilty, E. Christiaan Boerma, Arthur L. M. Tavy, Djamila Boerma, Can Ince, Intensive Care, University of Zurich, Biomedical Engineering and Physics, ACS - Microcirculation, Graduate School, Translational Physiology, and ACS - Atherosclerosis & ischemic syndromes
- Subjects
medicine.medical_specialty ,Mean arterial pressure ,Resuscitation ,business.industry ,RC86-88.9 ,Abdominal surgery ,610 Medicine & health ,Medical emergencies. Critical care. Intensive care. First aid ,Pathophysiology ,Microcirculation ,Red blood cell ,Blood pressure ,medicine.anatomical_structure ,Handheld vital microscopy ,Internal medicine ,Cardiology ,Medicine ,Hemodynamic management ,10023 Institute of Intensive Care Medicine ,business ,Perfusion ,Intestinal microcirculation - Abstract
Background: In clinical practice, blood pressure is used as a resuscitation goal on a daily basis, with the aim of maintaining adequate perfusion and oxygen delivery to target organs. Compromised perfusion is often indicated as a key factor in the pathophysiology of anastomotic leakage. This study was aimed at assessing the extent to which the microcirculation of the bowel coheres with blood pressure during abdominal surgery. Methods: We performed a prospective and observational cohort study. In patients undergoing abdominal surgery, the serosal microcirculation of either the small intestine or the colon was visualized using handheld vital microscopy (HVM). From the acquired HVM image sequences, red blood cell velocity (RBCv) and total vessel density (TVD) were calculated using MicroTools and AVA software, respectively. The association between microcirculatory parameters and blood pressure was assessed using Pearson's correlation analysis. We considered a two-sided P-value of 2. Mean arterial pressure (MAP) was 71 ± 12 mm Hg during microcirculatory imaging. MAP was not correlated with RBCv (Pearson's r = −0.049, P = 0.800) or TVD (Pearson's r = 0.310, P = 0.110). Conclusion: In 28 patients undergoing abdominal surgery, we found no association between serosal intestinal microcirculatory parameters and blood pressure.
- Published
- 2021