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Skin perfusion pressure as an indicator of tissue perfusion in valvular heart surgery: Preliminary results from a prospective, observational study.

DC FieldValueLanguage
dc.contributor.author곽영란-
dc.contributor.author박경은-
dc.contributor.author소사라-
dc.contributor.author송영-
dc.contributor.author심재광-
dc.date.accessioned2018-07-20T08:21:43Z-
dc.date.available2018-07-20T08:21:43Z-
dc.date.issued2017-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/161122-
dc.description.abstractHemodynamic management aims to provide adequate tissue perfusion, which is often altered during cardiac surgery with cardiopulmonary bypass (CPB). We evaluated whether skin perfusion pressure (SPP) can be used for monitoring of adequacy of tissue perfusion in patients undergoing valvular heart surgery. Seventy-two patients undergoing valve replacement were enrolled. SPP and serum lactate level were assessed after anaesthesia induction (baseline), during CPB, after CPB-off, end of surgery, arrival at intensive care unit, and postoperative 6 h. Lactate was further measured until postoperative 48 h. Association of SPP with lactate and 30-day morbidity comprising myocardial infarction, acute kidney injury, stroke, prolonged intubation, sternal infection, reoperation, and mortality was assessed. Among the lactate levels, postoperative 6 h peak value was most closely linked to composite of 30-day morbidity. The SPP value during CPB and its % change from the baseline value were significantly associated with the postoperative 6 h peak lactate (r = -0.26, P = 0.030 and r = 0.47, P = 0.001, respectively). Optimal cut-off of % decrease in SPP during CPB from baseline value for the postoperative 6 h hyperlactatemia was 48% (area under curve, 0.808; 95% confidence interval (CI), 0.652-0.963; P = 0.001). Decrease in SPP >48% during CPB from baseline value was associated with a 12.8-fold increased risk of composite endpoint of 30-day morbidity (95% CI, 1.48-111.42; P = 0.021) on multivariate logistic regression. Large decrease in SPP during CPB predicts postoperative 6 h hyperlactatemia and 30-day morbidity, which implicates a promising role of SPP monitoring in the achievement of optimal perfusion during CPB.-
dc.description.statementOfResponsibilityopen-
dc.languageEnglish-
dc.publisherPublic Library of Science-
dc.relation.isPartOfPLoS One-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAcute Kidney Injury/etiology-
dc.subject.MESHAged-
dc.subject.MESHArea Under Curve-
dc.subject.MESHCardiopulmonary Bypass/adverse effects-
dc.subject.MESHFemale-
dc.subject.MESHHeart Valve Diseases/mortality-
dc.subject.MESHHeart Valve Diseases/surgery-
dc.subject.MESHHemodynamics-
dc.subject.MESHHumans-
dc.subject.MESHHyperlactatemia/etiology-
dc.subject.MESHLactic Acid/blood-
dc.subject.MESHLogistic Models-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMyocardial Infarction/etiology-
dc.subject.MESHPostoperative Period-
dc.subject.MESHProspective Studies-
dc.subject.MESHROC Curve-
dc.subject.MESHSkin/physiopathology-
dc.subject.MESHStroke/etiology-
dc.subject.MESHSurvival Analysis-
dc.titleSkin perfusion pressure as an indicator of tissue perfusion in valvular heart surgery: Preliminary results from a prospective, observational study.-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Anesthesiology and Pain Medicine-
dc.contributor.googleauthorYoung Song-
dc.contributor.googleauthorSarah Soh-
dc.contributor.googleauthorJae-Kwang Shim-
dc.contributor.googleauthorKyoung-Un Park-
dc.contributor.googleauthorYoung-Lan Kwak-
dc.identifier.doi10.1371/journal.pone.0184555-
dc.contributor.localIdA00172-
dc.contributor.localIdA05125-
dc.contributor.localIdA01960-
dc.contributor.localIdA02036-
dc.contributor.localIdA02205-
dc.relation.journalcodeJ02540-
dc.identifier.eissn1932-6203-
dc.identifier.pmid28926643-
dc.contributor.alternativeNameKwak, Young Lan-
dc.contributor.alternativeNamePark, Kyoungun-
dc.contributor.alternativeNameSoh, Sa Rah-
dc.contributor.alternativeNameSong, Young-
dc.contributor.alternativeNameShim, Jae Kwang-
dc.contributor.affiliatedAuthorKwak, Young Lan-
dc.contributor.affiliatedAuthorPark, Kyoungun-
dc.contributor.affiliatedAuthorSoh, Sa Rah-
dc.contributor.affiliatedAuthorSong, Young-
dc.contributor.affiliatedAuthorShim, Jae Kwang-
dc.citation.volume12-
dc.citation.number9-
dc.citation.startPagee0184555-
dc.identifier.bibliographicCitationPLoS One, Vol.12(9) : e0184555, 2017-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers

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