Sublingual microcirculation in pancreatico-biliary surgery: An observational study
BACKGROUND: An observational cohort study was conducted to identify potential sublingual microcirculation parameters as a target for goal-directed fluid therapy.
METHODS: Patients that were scheduled for an open elective pancreatico-biliary surgery in Erasmus Medical Center were included. All patients underwent sublingual microcirculatory measurement at three time points: one day before surgery (T0), within the first 24 hours after surgery (T1) and on the fourth day after surgery (T2). The following parameters were obtained: microvascular flow index (MFI (AU)), Total vessels density (TVD (mm/mm2/)), Perfused vessels density (PVD (mm/mm2)), and proportion of perfused vessels (PPV (%)).
RESULTS: Sixteen patients were included in the final analysis. The differences between the time points T1 and T0 in patients without clinical significant complication and in patients with these complications gave a significant difference for PVD small vessels (PVDs) (delta PVDs mean -0.1 vs -8.2, p=0.01) and PPV small vessels (PPVs) (delta PPVs median 7.0 % vs -15.5 %, p=0.01).
CONCLUSION: The most significant microcirculatory parameter for a perioperative complicated course is the change of PVD and PPV. In the first 24 hours after surgery, if these parameters decrease there is a high chance of a complicated perioperative course.
|Keywords||Pancreatectomy, microcirculation, morbidity|
|Persistent URL||dx.doi.org/10.3233/ch-180448, hdl.handle.net/1765/121125|
|Journal||Clinical Hemorheology and Microcirculation|
Suker, M, Doncel, M.S.T., Lima, A.A.P., Ince, C, & van Eijck, C.H.J. (2019). Sublingual microcirculation in pancreatico-biliary surgery: An observational study. Clinical Hemorheology and Microcirculation, 72(3), 247–257. doi:10.3233/ch-180448