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Synchronous rhythmical vasomotion in the human cutaneous microvasculature during nonpulsatile cardiopulmonary bypass.

Publication ,  Journal Article
Podgoreanu, MV; Stout, RG; El-Moalem, HE; Silverman, DG
Published in: Anesthesiology
November 2002

BACKGROUND: The origin, control mechanisms, and functional significance of oscillations in microvascular flow are incompletely understood. Although the traditional belief has been that only low-frequency oscillations (0.04-0.10 Hz) can originate at the microvascular level, recent evidence in healthy volunteers has suggested that high-frequency oscillations (> 0.10 Hz) also may have a microvascular origin (as opposed to being mechanically transmitted respiratory-induced variations in stroke volume). The current study determined if such oscillations would emerge in the absence of cardiac and respiratory activity during nonpulsatile cardiopulmonary bypass (NP-CPB). METHODS: Forehead and finger laser Doppler flow, arterial pressure, and core temperature were simultaneously recorded in eight patients during NP-CPB. Analyses included time- domain indices, frequency-domain indices (auto power spectral density), and a measure of regularity (approximate entropy) for standardized time segments. RESULTS: Nonpulsatile cardiopulmonary bypass was associated with the emergence of rhythmical oscillations in laser Doppler flow, with characteristic frequencies for the forehead (0.13 +/- 0.03 Hz) and finger (0.07 +/- 0.02 Hz). Forehead vasomotion became progressively synchronized, with a gain in high-frequency spectral power from 17.5 (minute 1) to 89.1 (minute 40) normalized units, and a decrease in approximate entropy from 1.2 (before NP-CPB) to less than 0.5 (minute 40). CONCLUSIONS: The emergence of forehead microvascular oscillations at greater than 0.10 Hz (characteristic of parasympathetic frequency response), in the absence of cardiac and respiratory variability, demonstrates their peripheral origin and provides insights into parasympathetic vasoregulatory mechanisms. The progressive synchronization of forehead vasomotion during NP-CPB, suggestive of increased coupling among microvascular biologic oscillators, may represent a microcirculatory homeostatic response to systemic depulsation, with potential implications for end-organ perfusion.

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Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

November 2002

Volume

97

Issue

5

Start / End Page

1110 / 1117

Location

United States

Related Subject Headings

  • Skin
  • Regional Blood Flow
  • Middle Aged
  • Microcirculation
  • Male
  • Humans
  • Female
  • Cardiopulmonary Bypass
  • Anesthesiology
  • Aged
 

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Podgoreanu, M. V., Stout, R. G., El-Moalem, H. E., & Silverman, D. G. (2002). Synchronous rhythmical vasomotion in the human cutaneous microvasculature during nonpulsatile cardiopulmonary bypass. Anesthesiology, 97(5), 1110–1117. https://doi.org/10.1097/00000542-200211000-00012
Podgoreanu, Mihai V., Robert G. Stout, Habib E. El-Moalem, and David G. Silverman. “Synchronous rhythmical vasomotion in the human cutaneous microvasculature during nonpulsatile cardiopulmonary bypass.Anesthesiology 97, no. 5 (November 2002): 1110–17. https://doi.org/10.1097/00000542-200211000-00012.
Podgoreanu MV, Stout RG, El-Moalem HE, Silverman DG. Synchronous rhythmical vasomotion in the human cutaneous microvasculature during nonpulsatile cardiopulmonary bypass. Anesthesiology. 2002 Nov;97(5):1110–7.
Podgoreanu, Mihai V., et al. “Synchronous rhythmical vasomotion in the human cutaneous microvasculature during nonpulsatile cardiopulmonary bypass.Anesthesiology, vol. 97, no. 5, Nov. 2002, pp. 1110–17. Pubmed, doi:10.1097/00000542-200211000-00012.
Podgoreanu MV, Stout RG, El-Moalem HE, Silverman DG. Synchronous rhythmical vasomotion in the human cutaneous microvasculature during nonpulsatile cardiopulmonary bypass. Anesthesiology. 2002 Nov;97(5):1110–1117.

Published In

Anesthesiology

DOI

ISSN

0003-3022

Publication Date

November 2002

Volume

97

Issue

5

Start / End Page

1110 / 1117

Location

United States

Related Subject Headings

  • Skin
  • Regional Blood Flow
  • Middle Aged
  • Microcirculation
  • Male
  • Humans
  • Female
  • Cardiopulmonary Bypass
  • Anesthesiology
  • Aged