Haemodynamics, fluids & transfusion
Alteration of sublingual microcirculation in anemic patients during gastric cancer surgery under goal-directed fluid therapy: a prospective cohort study
Authors' conclusion
Under GDFT, anemic patients exhibited greater perioperative alterations in sublingual microcirculation, particularly after anesthesia induction and tumor resection. Lower preoperative Hb concentrations were associated with greater reductions in MFI. Further, the lack of detectable associations between macrocirculatory and sublingual microcirculatory variables suggests that conventional hemodynamic targets may not fully reflect sublingual microvascular perfusion in this vulnerable population.
Study context
- Population
- Patients undergoing open radical gastrectomy for gastric cancer under goal-directed fluid therapy guided by pulse pressure variationpatients analyzed
- Participants
- 49 patients
- Exposure
- Anemic vs non-anemic
- Anemicn = 22
- Non-anemicn = 27
- Outcome
- Microvascular flow index (MFI), group-by-time interaction
- Follow-up
- T0–T3
Main finding
As reported in the abstract
- Significant group-by-time interaction
- P = 0.030
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| MFI · T1 (immediately after induction of general anesthesia)Significantly lower in anemic patients | P = 0.013 |
| MFI · T3 (end of surgery)Between-group differences no longer evident | P = 0.461 |
| Proportion of perfused vessels (PPV) · T2 (after tumor resection)Lower in anemic patients | P = 0.010 |
MFI · T3 (end of surgery)
- MFI remained below baseline in both groups
Correlation of preoperative hemoglobin (Hb) with ΔMFI from T1 to T0
- Pearson's r
- 0.343
- P
- P = 0.016
- Lower preoperative Hb associated with greater reductions
Correlation of preoperative Hb with ΔMFI from T2 to T0
- Spearman's ρ
- 0.369
- P
- P = 0.009
- Lower preoperative Hb associated with greater reductions
Associations between macro- and micro-circulatory variables
- No significant associations in either group
Original publication
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