Observational studyJournal of cardiothoracic and vascular anesthesia2021
Severe Impairment of Microcirculatory Perfused Vessel Density Is Associated With Postoperative Lactate and Acute Organ Injury After Cardiac Surgery.
Observational study in Journal of cardiothoracic and vascular anesthesia, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis 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.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 57 citations in OpenAlex.
- Effects of regional cerebral oxygen saturation monitoring on postoperative cognitive dysfunction in older patients: a systematic review and meta-analysis.BMC geriatrics · 2023Pooled 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
- Article
- Intraoperative Dynamics of Lactate, pH, and Bicarbonate During Cardiac Surgery: A Prospective Study Exploring a Composite Metabolic Marker of Reperfusion Stress.Diagnostics (Basel, Switzerland) · 2026Article
- Postoperative Hematocrit and Lactate Trajectory After Neonatal Cardiopulmonary Bypass: A Retrospective Cohort Study.Pediatric cardiology · 2026Article
- Microcirculation and Cerebrovascular Autoregulation in Patients With Mechanical Circulatory Support Devices.Journal of stroke · 2026Review
- Diagnostic Value of End-Tidal Carbon Dioxide Combined With Lactate for Early Detection of Sepsis in Prehospital Patients: A Prospective Cohort Study.Medical science monitor : international medical journal of experimental and clinical research · 2026Article
- Sympathetic Stress and Sleep Loss in Diabetic Retinopathy: Links to Retinal Blood-Flow Control.Biomedicines · 2026Review
- Observational Study of Sublingual Microcirculation in Patients With Chronic Cardiovascular Disease.Microcirculation (New York, N.Y. : 1994) · 2025Observational
- Effect of extracorporeal membrane oxygenation combined with hemoperfusion on inflammatory factors in patients with cardiogenic shock.World journal of cardiology · 2025Article
- A model of anaerobic tissue perfusion during trauma-Lactate trajectory curvature can determine recovery.PLoS computational biology · 2025Article
- Microcirculatory Monitoring in Children with Congenital Heart Disease Before and After Cardiac Surgery.Journal of cardiovascular translational research · 2023Observational
- Low postoperative perfused vessel density is associated with increased soluble endothelial cell adhesion molecules during circulatory shock after cardiac surgery.Microvascular research · 2023Article
- Angiopoietin-2 is associated with capillary leak and predicts complications after cardiac surgery.Annals of intensive care · 2023Article
- The sublingual microcirculation and frailty index in chronic kidney disease patients.Microcirculation (New York, N.Y. : 1994) · 2023Article
- Monitoring of the microcirculation in children undergoing major abdominal and thoracic surgery: A pilot study.Clinical hemorheology and microcirculation · 2023Article
- Hemodynamic Effect of Pulsatile on Blood Flow Distribution with VA ECMO: A Numerical Study.Bioengineering (Basel, Switzerland) · 2022Article
- Topical nitroglycerin to detect reversible microcirculatory dysfunction in patients with circulatory shock after cardiovascular surgery: an observational study.Scientific reports · 2022Observational
- Article
- Case Report: Early Identification of Subclinical Cardiac Tamponade in a Patient With a Left Ventricular Assist Device by the Use of Sublingual Microcirculatory Imaging: A New Diagnostic Imaging Tool?Frontiers in cardiovascular medicine · 2022Article
Corrections and comments
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Authors and funding
15 authors at 5 institutions in 3 countries.
Funding
Abstract
objectiveResuscitation after cardiac surgery needs to address multiple pathophysiological processes that are associated with significant morbidity and mortality. Functional microcirculatory derangements despite normal systemic hemodynamics have been previously described but must be tied to clinical outcomes. The authors hypothesized that microcirculatory dysfunction after cardiac surgery would include impaired capillary blood flow and impaired diffusive capacity and that subjects with the lowest quartile of perfused vessel density would have an increased postoperative lactate level and acute organ injury scores.
designProspective, observational study.
settingA single, tertiary university cardiovascular surgical intensive care unit.
participants25 adults undergoing elective cardiac surgery requiring cardiopulmonary bypass.
interventionSublingual microcirculation was imaged using incident dark field microscopy before and 2 to 4 hours after surgery in the intensive care unit. MEASUREMENTS AND MAIN
resultsCompared with baseline measurements, postoperative vessel-by-vessel microvascular flow index (2.9 [2.8-2.9] v 2.5 [2.4-2.7], p < 0.0001) and perfused vessel density were significantly impaired (20.7 [19.3-22.9] v 16.3 [12.8-17.9], p < 0.0001). The lowest quartile of perfused vessel density (<12.8 mm/mm
conclusionIn patients undergoing cardiac surgery, there was a significant decrease in postoperative microcirculatory convective blood flow and diffusive capacity during early postoperative resuscitation. Severely impaired perfused vessel density, represented by the lowest quartile of distribution, is significantly related to hyperlactatemia and early organ injury.
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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.