Microcirculatory response during on-pump versus off-pump coronary artery bypass graft surgery

Bienz, Marc; Drullinsky, David; Stevens, Louis-Mathieu; Bracco, David; Noiseux, Nicolas

doi:10.1177/0267659115590481

Cited by 22 publications

(17 citation statements)

References 32 publications

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“…These authors also reported that off-pump procedures are associated with severe but distinct alterations in microcirculatory function that are mediated by different mechanisms compared with on-pump surgery. A recent study by Bienz et al [26] found that OPCABG does not preserve postoperative microcirculatory parameters better than those in ONCABG. These authors only found that temperature might have a positive effect on the microcirculation [26].…”

Section: Microcirculatory Alterations During Cardiac Surgerymentioning

confidence: 94%

“…A recent study by Bienz et al [26] found that OPCABG does not preserve postoperative microcirculatory parameters better than those in ONCABG. These authors only found that temperature might have a positive effect on the microcirculation [26].…”

Section: Microcirculatory Alterations During Cardiac Surgerymentioning

confidence: 94%

“…An experimental study revealed that compared with normothermia, mild hypothermia (348C) causes reductions in ventricular function, oxygen extraction, and microvascular flow and that the microcirculatory values recover with the correction of the temperature [46]. As previously mentioned, Bienz et al found that prolonged exposure to hypothermic temperatures has negative effects and that the active warming of patients can elicit positive effects on the microcirculation during CPB [26].…”

Section: Microcirculatory Alterations During Cardiac Surgerymentioning

confidence: 96%

“…Other changes, including hypotension, hemodilution, hypothermia, cardiac arrest, and a change from pulsatile to nonpulsatile flow, adds to detrimental effects on the microcirculation and lead to tissue hypoxia and organ failure during standard CABG surgery with CPB [on-pump CABG (ONCABG)] [21][22][23][24][25]. The lessinvasive OPCABG reduces perioperative complications and can serve as an alternative to ONCABG that offers pulsatile flow without the need for extracorporeal circulation [26]. The OPCABG procedure has been associated with improved renal and pulmonary outcomes, shorter lengths of hospitalization and a reduction in myocardial injury compared with ONCABG [27][28][29][30].…”

Section: Microcirculatory Alterations During Cardiac Surgerymentioning

confidence: 99%

See 3 more Smart Citations

The response of the microcirculation to cardiac surgery

Kara

Akın

İnce

2016

Current Opinion in Anaesthesiology

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Section: Microcirculatory Alterations During Cardiac Surgerymentioning

confidence: 94%

Section: Microcirculatory Alterations During Cardiac Surgerymentioning

confidence: 94%

Section: Microcirculatory Alterations During Cardiac Surgerymentioning

confidence: 96%

Section: Microcirculatory Alterations During Cardiac Surgerymentioning

confidence: 99%

See 2 more Smart Citations

The response of the microcirculation to cardiac surgery

Kara

Akın

İnce

2016

Current Opinion in Anaesthesiology

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“…Data from the P1 has previously been published. 24 The third dataset was prospectively acquired from three healthy volunteer participants. Volunteer participants did not receive any anesthesia or undergo any surgical procedure (V1).…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Automated Microvascular Flow Analysis Software AVA 4.0: A Validation Study

Guay

Khebir

Shahiri

et al. 2020

Preprint

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BACKGROUND: Real-time automated analysis of videos of the microvasculature is an essential step in the development of research protocols and clinical algorithms that incorporate point-of-care microvascular analysis. Validation studies on the software packages developed to perform these analyses have reported low agreement with the current referent standard semi-automated analysis method. In response to the call for validation studies of available automated analysis software by the European Society of Intensive Care Medicine, we report the first human validation study of AVA 4.0. METHODS: Two retrospective perioperative datasets of human microcirculation videos (P1 and P2) and one prospective healthy volunteer dataset (V1) were used. Video quality was assessed using the Microcirculation Image Quality Selection (MIQS) score. Videos were initially analysed with (1) AVA software 3.2 by two experienced users through a semi-manual method, followed by an analysis with (2) AVA automated software 4.0 for perfused vessel density (PVD), total vessel density (TVD), and proportion of perfused vessels (PPV). Bland-Altman analysis and intraclass correlation coefficients (ICC) were used to measure agreement between the two methods. Each method’s ability to discriminate between microcirculatory states before and after induction of general anesthesia was assessed using paired t-tests. RESULTS: Fifty-two videos from P1, 128 videos from P2 and 26 videos from V1 met inclusion criteria for analysis. Correlational analysis and Bland Altman analysis revealed poor agreement and no correlation between AVA 4.0 and AVA 3.2. Increasing video length did not improve agreement. Automated analysis consistently underestimated measures of vessel density. Following the induction of anesthesia, TVD and PVD measured using AVA 3.2 increased significantly for P1 and P2 (p < 0.05). However, these changes could not be replicated with the data generated by AVA 4.0. CONCLUSIONS: AVA 4.0 is not a suitable tool for research or clinical purposes at this time. Future validation studies of automated microvascular flow analysis software should aim to measure the new software’s agreement with the referent standard, its ability to discriminate between clinical states and the quality thresholds at which its performance becomes unacceptable.

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