SynthesisCritical care (London, England)2020
Microcirculatory perfusion disturbances following cardiopulmonary bypass: a systematic review.
Synthesis in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 2 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Effects of albumin and crystalloid priming strategies on red blood cell transfusions in on-pump cardiac surgery: a network meta-analysis.BMC anesthesiology · 2024Pooled it
- Intraoperative Goal-Directed Perfusion in Cardiac Surgery with Cardiopulmonary Bypass: The Roles of Delivery Oxygen Index and Cardiac Index.Annals of thoracic and cardiovascular surgery : official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia · 2024Pooled it
- Intraoperative Dexmedetomidine Enhances Postoperative Microcirculation and Reduces Acute Kidney Injury in Cardiac Surgery: A Double-Blind Randomized Trial.Drug design, development and therapy · 2025Trial
- Association Between Intra-Aortic Balloon Pump Support and Whole Blood Viscosity Following Cardiopulmonary Bypass.Artificial organs · 2026Observational
- The Association of NT-proBNP With Maximum Tongue Pressure After Cardiac Surgery: A Cross-Sectional Study.Journal of oral rehabilitation · 2026Article
- Imbalance between oxygen delivery and consumption during cooling and rewarming phases of cardiopulmonary bypass and association with hyperlactatemia in total aortic arch replacement: a prospective observational study.Journal of cardiothoracic surgery · 2026Observational
- Microcirculatory response and leukocyte activation in patients undergoing elective cardiac surgery with cardiopulmonary bypass.Journal of intensive medicine · 2026Article
- Microcirculation and Cerebrovascular Autoregulation in Patients With Mechanical Circulatory Support Devices.Journal of stroke · 2026Review
- Sympathetic Stress and Sleep Loss in Diabetic Retinopathy: Links to Retinal Blood-Flow Control.Biomedicines · 2026Review
- Microcirculation dysfunction and cardioprotection in cardiac surgery with cardiopulmonary bypass: mechanisms, monitoring, and therapeutic strategies.Frontiers in cardiovascular medicine · 2026Review
- 4D-Micro: a tiered, testable framework for hemodynamic-tissue perfusion mismatch in cardiac surgery.Frontiers in cardiovascular medicine · 2026Article
- Pharmacological strategies for myocardial protection in cardiac surgery: current science and the emerging role of multi-omics and artificial intelligence.Frontiers in cardiovascular medicine · 2026Review
- Endothelial glycocalyx thickness in cats with naturally occurring trauma or non-traumatic illness: an exploratory study.Frontiers in veterinary science · 2026Article
- Razuprotafib Does Not Improve Microcirculatory Perfusion Disturbances nor Renal Edema in Rats on Extracorporeal Circulation.International journal of molecular sciences · 2025Article
- Management of cardiopulmonary bypass in pregnancy: challenges and progress in maternal-fetal protection.Frontiers in cardiovascular medicine · 2025Review
- Article
- Association between cardiopulmonary bypass duration and early major adverse cardiovascular events after surgical repair of supravalvular aortic stenosis.Frontiers in cardiovascular medicine · 2025Article
- Lactated Ringers, albumin and mannitol as priming during cardiopulmonary bypass reduces pulmonary edema in rats compared with hydroxyethyl starch.Intensive care medicine experimental · 2024Article
- From bench to bedside: A review of the application and potential of microcirculatory assessment by hand-held videomicroscopy.International journal of cardiology. Heart & vasculature · 2024Review
- Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundMicrocirculatory perfusion disturbances are associated with increased morbidity and mortality in patients undergoing cardiac surgery with cardiopulmonary bypass (CPB). Technological advancements made it possible to monitor sublingual microcirculatory perfusion over time. The goal of this review is to provide an overview of the course of alterations in sublingual microcirculatory perfusion following CPB. The secondary goal is to identify which parameter of sublingual microcirculatory perfusion is most profoundly affected by CPB.
methodsPubMed and Embase databases were systematically searched according to PRISMA guidelines and as registered in PROSPERO. Studies that reported sublingual microcirculatory perfusion measurements before and after onset of CPB in adult patients undergoing cardiac surgery were included. The primary outcome was sublingual microcirculatory perfusion, represented by functional capillary density (FCD), perfused vessel density (PVD), total vessel density (TVD), proportion of perfused vessels (PPV), and microvascular flow index (MFI).
resultsThe search identified 277 studies, of which 19 fulfilled all eligibility criteria. Initiation of CPB had a profound effect on FCD, PVD, or PPV. Seventeen studies (89%) reported one or more of these parameters, and in 11 of those studies (65%), there was a significant decrease in these parameters during cardiac surgery; the other 6 studies (35%) reported no effect. In 29% of the studies, FCD, PVD, or PPV normalized by the end of cardiac surgery, and in 24% percent of the studies, this effect lasted at least 24 h. There was no clear effect of CPB on TVD and a mixed effect on MFI.
conclusionCPB during cardiac surgery impaired sublingual microcirculatory perfusion as reflected by reduced FCD, PVD, and PPV. Four studies reported this effect at least 24 h after surgery. Further research is warranted to conclude on the duration of CPB-induced microcirculatory perfusion disturbances and the relationship with clinical outcome.
trial registrationPROSPERO, CRD42019127798.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.