title: Microcirculatory response during on-pump versus off-pump coronary artery bypass graft surgery.
abstract: OBJECTIVE
  The use of cardiopulmonary bypass (CPB) during coronary artery bypass graft surgery (CABG) is associated with a systemic inflammatory response, resulting in altered microcirculation. The aim of this study was to evaluate whether beating heart surgery can preserve the microcirculation.
  
  
  METHODS
  Sublingual microcirculation was characterized by a Sidestream Darkfield Imaging Microscope during off-pump (OPCABG) and on-pump (ONCABG) surgery. Microcirculatory parameters were evaluated during eight precise perioperative time points.
  
  
  RESULTS
  The quality of the microcirculation decreased during early ONCABG. OPCABG resulted in a significantly better microcirculation compared to ONCABG for three of six parameters during surgery. However, by the end of surgery and postoperatively, the microcirculatory parameters were no different between the groups.
  
  
  CONCLUSIONS
  While the results do not show a marked preservation of the microcirculation during and after OPCABG compared to ONCABG, they coincide with the body temperature fluctuations of each group during and after surgery. Our work suggests that active warming could impact the microcirculation parameters.
authors.affiliation: Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.
authors.forename: Marc
authors.initials: M
authors.lastname: Bienz
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, McGill University Hospital Center (MUHC), Montreal, Quebec, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Drullinsky
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada.
authors.forename: Louis-Mathieu
authors.initials: LM
authors.lastname: Stevens
authors.affiliation: Department of Anesthesia, MUHC, Montreal, Quebec, Canada.
authors.forename: David
authors.initials: D
authors.lastname: Bracco
authors.affiliation: Department of Surgery, Division of Cardiac Surgery, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, Quebec, Canada noiseuxn@videotron.ca.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Noiseux
mesh_terms: D000368:Aged; D001831:Body Temperature; D047549:Coronary Artery Bypass, Off-Pump; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D018746:Systemic Inflammatory Response Syndrome / Q000503:physiopathology* / Q000601:surgery*
keywords: beating heart surgery; cardiopulmonary bypass; coronary artery bypass graft surgery; sublingual microcirculation