Perioperative trajectory of plasma viscosity: A prospective, observational, exploratory study in cardiac surgery

IF 1.9 4区医学 Q3 HEMATOLOGY

Microcirculation Pub Date : 2022-07-15 DOI:10.1111/micc.12777

Liana Valeanu, Stefan Andrei, Carmen Ginghina, Cornel Robu, Adrian Ciurciun, Cosmin Balan, Mihai Stefan, Anca Stoian, Iulia Stanculea, Andreea Cheta, Laura Dima, Ovidiu Stiru, Daniela Filipescu, Serban-Ion Bubenek-Turconi, Dan Longrois

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引用次数: 3

Abstract

Objective

Plasma viscosity is one of the critical factors that regulate microcirculatory flow but has received scant research attention. The main objective of this study was to evaluate plasma viscosity in cardiac surgery with respect to perioperative trajectory, main determinants, and impact on outcome.

Methods

Prospective, single center, observational study, including 50 adult patients undergoing cardiac surgery with cardiopulmonary bypass between February 1, 2020 and May 31, 2021. Clinical perioperative characteristics, short term outcome, standard blood analysis, plasma viscosity, total proteins, and fibrinogen concentrations were recorded at 10 distinct time points during the first perioperative week.

Results

The longitudinal analysis showed that plasma viscosity is strongly influenced by proteins and measurement time points. Plasma viscosity showed a coefficient of variation of 11.3 ± 1.08 for EDTA and 12.1 ± 2.1 for citrate, similarly to total proteins and hemoglobin, but significantly lower than fibrinogen (p < .001). Plasma viscosity had lower percentage changes compared to hemoglobin (RANOVA, p < .001), fibrinogen (RANOVA, p < .001), and total proteins (RANOVA, p < .001). The main determinant of plasma viscosity was protein concentrations. No association with outcome was found, but the study may have been underpowered to detect it.

Conclusion

Plasma viscosity had a low coefficient of variation and low perioperative changes, suggesting tight regulation. Studies linking plasma viscosity with outcome would require large patient cohorts.

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血浆粘度的围手术期轨迹:一项前瞻性、观察性、探索性的心脏外科研究

目的血浆黏度是调节微循环血流的关键因素之一，但目前研究较少。本研究的主要目的是评估心脏手术中血浆粘度与围手术期轨迹、主要决定因素和对结果的影响。方法前瞻性、单中心、观察性研究，纳入2020年2月1日至2021年5月31日期间接受心脏手术合并体外循环的50例成年患者。在围手术期第一周的10个不同时间点记录临床围手术期特征、短期预后、标准血分析、血浆粘度、总蛋白和纤维蛋白原浓度。结果纵向分析表明，血浆粘度受蛋白质和测量时间点的影响较大。血浆粘度变化系数显示EDTA为11.3±1.08，柠檬酸盐为12.1±2.1，与总蛋白和血红蛋白相似，但显著低于纤维蛋白原(p < .001)。与血红蛋白(RANOVA, p < 0.001)、纤维蛋白原(RANOVA, p < 0.001)和总蛋白(RANOVA, p < 0.001)相比，血浆粘度的变化百分比较低。血浆粘度的主要决定因素是蛋白质浓度。没有发现与结果的联系，但这项研究可能没有足够的能力来检测它。结论血浆粘度变化系数小，围手术期变化小，有严密的调控。将血浆粘度与结果联系起来的研究需要大量的患者队列。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Microcirculation 医学-外周血管病

CiteScore

5.00

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The journal features original contributions that are the result of investigations contributing significant new information relating to the vascular and lymphatic microcirculation addressed at the intact animal, organ, cellular, or molecular level. Papers describe applications of the methods of physiology, biophysics, bioengineering, genetics, cell biology, biochemistry, and molecular biology to problems in microcirculation. Microcirculation also publishes state-of-the-art reviews that address frontier areas or new advances in technology in the fields of microcirculatory disease and function. Specific areas of interest include: Angiogenesis, growth and remodeling; Transport and exchange of gasses and solutes; Rheology and biorheology; Endothelial cell biology and metabolism; Interactions between endothelium, smooth muscle, parenchymal cells, leukocytes and platelets; Regulation of vasomotor tone; and Microvascular structures, imaging and morphometry. Papers also describe innovations in experimental techniques and instrumentation for studying all aspects of microcirculatory structure and function.