Abstract
To evaluate parameters of the vascular occlusion test (VOT) before, during, and after pulsatile cardiopulmonary bypass (CPB). Prospective, observational study. Single-center university hospital. Adult patients undergoing elective cardiac surgery with pulsatile CPB. An oximeter sensor and adult-sized pneumatic tourniquet were positioned at the right forearm. A VOT with a predefined ischemic time of 3 minutes was performed before, during, and after CPB. Changes in tissue oxygen saturation were recorded. Thirty-four patients who underwent cardiac surgery were enrolled in the study. The lowest tissue oxygen saturation measured during the ischemic challenge differed among all 3 stages of surgery, with median values of 62.9% before, 57.5% during, and 59.3% after perfusion (p<0.05). Both occlusion (p<0.001) and reperfusion (p<0.05) slopes were steeper after bypass compared with before initiating bypass, whereas the reperfusion time remained constant among the different time points. The microcirculatory function as demonstrated by changes in VOT parameters was enhanced during and after normothermic pulsatile CPB. Clinical relevance, however, needs to be further explored.
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