Microcirculatory changes in children undergoing cardiac surgery: A prospective observational study

S. Scolletta, D. Marianello, G. Isgrò, A. Dapoto, V. Terranova, F. Franchi, E. Baryshnikova, C. Carlucci, M. Ranucci

Research output: Contribution to journalArticle

Abstract

Background The effects of cardiac surgery on the microcirculation of children are unknown. The aim of this study was to assess the microcirculatory changes in children undergoing surgery for correction of congenital heart disease. Methods We used a videomicroscope (Sidestream Dark Field, SDF) in a convenience sample of 24 children <five yr old. Total vascular density (TVD, vessels mm-2), microvascular flow index (MFI, arbitrary units), proportion of perfused small vessels (PPV, percentage), and perfused vessel density (PVD) were obtained after induction of anaesthesia (T1), at the end of the surgical procedure (T2), after intensive care unit (ICU) admission (T3), and at six h (T4) and 12h (T5) after ICU admission. Results Microcirculatory variables did not significantly change over time. Haemodynamic parameters and microcirculatory variables were not correlated. In a subanalysis conducted for cyanotic (n=7) and acyanotic (n=17) children, repeated measures ANOVA showed a significant interaction between time and the presence of cyanosis for PPV (P=0.03), TVD (P=0.03), and PVD (P=0.03). Weak inverse correlations were found between storage time of transfused red blood cell (RBCs) and MFI at T3 (r=-0.63, P=0.01) and T4 (r=-0.53, P=0.03). Conclusions Microcirculatory variables have a different time-related trend in cyanotic and acyanotic children undergoing cardiac surgery. The storage time of transfused RBCs seems to negatively impact the microcirculation. Further and larger studies are warranted to prove the potential implications of this study.

Original languageEnglish
Pages (from-to)206-213
Number of pages8
JournalBritish Journal of Anaesthesia
Volume117
Issue number2
DOIs
Publication statusPublished - Aug 1 2016

Keywords

  • cardiac surgery
  • congenital heart disease
  • microcirculation
  • paediatric intensive care units

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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