ArticleCureus2025
Advanced Metabolic-Guided Perfusion Concepts in an Obese Patient Undergoing Cardiac Surgery: A Case Report.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Obesity increases metabolic oxygen demand, impairs microvascular reserve, and reduces tolerance to hemodilution during cardiopulmonary bypass (CPB), making adequate indexed oxygen delivery (DO₂i) especially important. Evidence on DO₂i-guided perfusion in obese patients undergoing redo cardiac surgery remains limited. We report the case of a 61-year-old obese woman (125 kg; BSA 2.23 m²) undergoing redo mitral valve replacement and tricuspid repair. Her elevated oxygen requirements and prolonged CPB time placed her at high risk for oxygen-delivery instability. Continuous metabolic monitoring integrated DO₂i, indexed carbon-dioxide production (VCO₂i), oxygen consumption index (VO₂i), mixed venous oxygen saturation (SvO₂), temperature-corrected oxygen-extraction ratio (O₂Eri), and the DO₂/VCO₂ ratio. Because the procedure was performed at 30°C, DO₂i was adjusted using a Q₁₀-based correction to reflect reduced metabolic demand under moderate hypothermia. A goal-directed perfusion strategy targeting a temperature-corrected DO₂i ≥ 300 mL/min/m² enabled early detection and correction of transient DO₂i declines (nadir 260 mL/min/m²). Cumulative AUC-DO₂ remained <1,000 mL/min/m²/min, with minimal exposure to DO₂i <280 mL/min/m². Aerobic metabolism was preserved throughout CPB, postoperative lactate stayed low, no acute kidney injury developed, and recovery was uncomplicated. This case shows that integrating DO₂i with advanced metabolic indices and temperature-adjusted analysis can enhance predictive perfusion management in obese high-risk patients. Further research is needed to define optimal DO₂i thresholds and temperature-specific GDP strategies for this population.
Indexed as
Identifiers
What OpenQuestion holds
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.