ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Evaluation of microcirculation with tissue oxygen saturation monitoring in open heart surgery
Jülide Sayın Kart1, Halim Ulugöl1, Cem Arıtürk2, Uğur Aksu3, Murat Ökten2, Hasan Karabulut2, Fevzi Toraman1
1Acıbadem Üniversitesi Tıp Fakültesi, Anesteziyoloji ve Reanimasyon Anabilim Dalı, İstanbul, Türkiye
2Acıbadem Üniversitesi Tıp Fakültesi, Kalp ve Damar Cerrahisi Anabilim Dalı, İstanbul, Türkiye
3İstanbul Üniversitesi, Biyoloji Fakültesi, İstanbul, Türkiye
DOI : 10.5606/tgkdc.dergisi.2015.11278
Background: In this study, we aimed to identify the potential period which microcirculation tends to mostly deteriorate and other hemodynamic and arterial blood gas parameters associated with microcirculation in patients undergoing elective open heart surgery with extracorporeal circulation.

Methods: Twenty adult patients (12 males, 8 females; mean age 56.4 years; range 38 to 77 years) who were scheduled for elective first-time open heart surgery were prospectively included in the study. Tissue oxygen saturation heart rate, pulse oximetry, electrocardiography, invasive arterial blood pressure monitoring, bispectral index, and regional cerebral oxygen saturation monitoring were performed. Measurements were repeated and recorded before anesthesia induction, preoperatively, and postoperatively.

Results: The lowest tissue oxygen saturation values and the highest % alteration of the right and left regional cerebral oxygen saturation were in the re-warming period perioperatively with 69±2%, –17±2%, –14±2%, respectively. The lowest values in postoperative period were measured at the postoperative first hour with 59±2%, –15±4%, –12±3%, respectively. Reductions in the tissue oxygen saturation, lactate and regional cerebral oxygen saturation values were statistically significantly correlated with each other (p<0.05).

Conclusion: Hypotermia, hemodilution and nonpulsatile flow during and after extracorporeal circulation may deteriorate microcirculation; however, standard monitoring variables may fail to detect this deterioration timely. We believe that microcirculation evaluation with standard monitorization with the addition of tissue oxygen saturation monitorization may be of significance for the outcome variables.

Keywords : Extracorporeal circulation; microcirculation; tissue oxygen saturation
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