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Perfusion
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Peripheral tissue perfusion during coronary artery bypass grafting

Kari Kuttila

Department of Surgery, University of Turku

Juha Niinikoski

Department of Surgery, University of Turku

Central haemodynamics, peripheral tissue perfusion and blood lactate concentration were studied in eight male patients undergoing coronary artery bypass grafting, being operated upon under moderate haemodilution and systemic hypothermia. Peripheral tissue perfusion was assessed by continuous recordings of subcutaneous tissue PO2 (PscO2), skin red cell flux (RCF) and transcutaneous PO2 (PtcO2) in the upper extremity. PtcO2 index (= PtcO2/arterial PO2) was determined and finger-tip temperature (Tft) serially measured. PaO2 and PtcO2 reached maximum values during the extracorporeal circulation (ECC) at the deepest hypothermia, whereas PscO2, PtcO2 index, RCF and Tft decreased markedly during ECC, rose during rewarming and fell again towards the end of surgery. Lactate accumulated in the blood especially after coming off bypass. These data suggest that the patients develop hypoperfusion and hypoxia of the peripheral tissues during extracorporeal circulation and again at the end of operation despite seemingly adequate central haemodynamics. This is possibly caused by the cooling and vasoconstriction of the peripheral vascular bed.

Perfusion, Vol. 4, No. 1, 25-31 (1989)
DOI: 10.1177/026765918900400104
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