Microcirculatory Monitoring in Children with Congenital Heart Disease Before and After Cardiac Surgery

In this prospective observational study, we investigated whether congenital heart disease (CHD) affects the microcirculation and whether the microcirculation is altered following cardiac surgery with cardiopulmonary bypass (CPB). Thirty-eight children with CHD undergoing cardiac surgery with CPB and...

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Bibliographic Details
Published in:Journal of cardiovascular translational research 2023-12, Vol.16 (6), p.1333-1342
Main Authors: Erdem, Özge, de Graaff, Jurgen C., Hilty, Matthias P., Kraemer, Ulrike S., de Liefde, Inge I., van Rosmalen, Joost, Ince, Can, Tibboel, Dick, Kuiper, Jan Willem
Format: Article
Language:English
Subjects:
Biomedical Engineering and Bioengineering
Biomedicine
Cardiac Surgical Procedures - adverse effects
Cardiology
Cardiopulmonary Bypass - adverse effects
Child
Heart Defects, Congenital - diagnostic imaging
Heart Defects, Congenital - surgery
Human Genetics
Humans
Medicine
Medicine & Public Health
Microcirculation
Original Article
Prospective Studies
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Summary:In this prospective observational study, we investigated whether congenital heart disease (CHD) affects the microcirculation and whether the microcirculation is altered following cardiac surgery with cardiopulmonary bypass (CPB). Thirty-eight children with CHD undergoing cardiac surgery with CPB and 35 children undergoing elective, non-cardiac surgery were included. Repeated non-invasive sublingual microcirculatory measurements were performed with handheld vital microscopy. Before surgery, children with CHD showed similar perfused vessel densities and red blood cell velocities (RBCv) but less perfused vessels ( p < 0.001), lower perfusion quality ( p < 0.001), and higher small vessel densities ( p = 0.039) than children without CHD. After cardiac surgery, perfused vessel densities and perfusion quality of small vessels declined ( p = 0.025 and p = 0.032), while RBCv increased ( p = 0.032). We demonstrated that CHD was associated with decreased microcirculatory perfusion and increased capillary recruitment. The microcirculation was further impaired after cardiac surgery. Decreased microcirculatory perfusion could be a warning sign for altered tissue oxygenation and requires further exploration. Graphical abstract
ISSN:1937-5387
1937-5395
DOI:10.1007/s12265-023-10407-4