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Article

Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass

1
Department of Anesthesiology, Amsterdam UMC, VU University, 1081 HV Amsterdam, The Netherlands
2
Departments Physiology and Cardiothoracic Surgery, Amsterdam UMC, VU University, 1081 HV Amsterdam, The Netherlands
3
Department of Cardiothoracic Surgery, Amsterdam UMC, VU University, 1081 HV Amsterdam, The Netherlands
4
Faculty of Medicine, Amsterdam UMC, VU University, 1081 BT Amsterdam, The Netherlands
5
Department of Intensive Care, Amsterdam UMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
*
Author to whom correspondence should be addressed.
Academic Editor: Didac Mauricio
J. Clin. Med. 2021, 10(3), 469; https://doi.org/10.3390/jcm10030469
Received: 18 December 2020 / Revised: 18 January 2021 / Accepted: 22 January 2021 / Published: 26 January 2021
(This article belongs to the Special Issue Management of the Perioperative Diabetic Patients)
Obesity is a frequent comorbidity among patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Cardiac surgery with CPB impairs microcirculatory perfusion, which is associated with multiple organ failure. As microvascular function is frequently compromised in obese patients, we studied whether cardiac surgery with CPB has a more detrimental effect on microcirculatory perfusion in obese patients. Sublingual microcirculatory perfusion was measured with sidestream dark field (SDF) imaging in obese patients (body mass index ≥32 kg/m2; n = 14) without type II diabetes mellitus and in lean patients (BMI 20–25 kg/m2; n = 22) undergoing cardiac surgery with CPB. CPB reduced systolic blood pressure and mean arterial pressure more profoundly in lean compared with obese patients (SBP: 38% vs. 18%; MAP: 11% vs. 8%, p < 0.05), and both restored after weaning from CPB. No differences were present in intraoperative glucose, hematocrit, hemoglobin, lactate, and blood gas values between obese and lean patients. Microcirculatory perfusion did not differ between obese and lean patients the day before surgery. CPB decreased microcirculatory perfusion with 9% in both groups, but this was only significant in lean patients (p < 0.05). Three days following surgery, microcirculatory perfusion was restored in both groups. In conclusion, microcirculatory perfusion was equally disturbed during cardiac surgery with CPB in metabolically healthy obese patients compared to lean patients. View Full-Text
Keywords: cardiac surgery; cardiopulmonary bypass; microcirculation; obesity; SDF; perfusion cardiac surgery; cardiopulmonary bypass; microcirculation; obesity; SDF; perfusion
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MDPI and ACS Style

Boly, C.A.; Venhuizen, M.; Dekker, N.A.M.; Vonk, A.B.A.; Boer, C.; Brom, C.E.v.d. Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass. J. Clin. Med. 2021, 10, 469. https://doi.org/10.3390/jcm10030469

AMA Style

Boly CA, Venhuizen M, Dekker NAM, Vonk ABA, Boer C, Brom CEvd. Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass. Journal of Clinical Medicine. 2021; 10(3):469. https://doi.org/10.3390/jcm10030469

Chicago/Turabian Style

Boly, Chantal A., Margot Venhuizen, Nicole A. M. Dekker, Alexander B. A. Vonk, Christa Boer, and Charissa E. van den Brom. 2021. "Comparison of Microcirculatory Perfusion in Obese and Non-Obese Patients Undergoing Cardiac Surgery with Cardiopulmonary Bypass" Journal of Clinical Medicine 10, no. 3: 469. https://doi.org/10.3390/jcm10030469

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