A prospective, observational single-center study was carried out. Pediatric patients undergoing congenital heart defect surgery were evaluated before, during, and after surgery. At each time point, sublingual microcirculation and clinical parameters were assessed, along with analytical variables. Twenty-four patients were included. All microcirculatory parameters worsened during cardiopulmonary bypass and returned to baseline values after surgery (p ≤ 0.001). In the intraoperative evaluation, body temperature correlated with perfused small vessel density (p = 0.014), proportion of perfused small vessels (p < 0.001), small vessel microvascular flow index (p = 0.003), and small vessel heterogeneity index (p < 0.002). Patients with cyanotic disease exhibited higher small vessel density (p < 0.008) and higher density of perfused small vessels (p < 0.022) at baseline, and a lower microvascular flow index (p = 0.022) and higher heterogeneity (p = 0.026) in the intraoperative phase. Children with congenital heart disease exhibited decreased vascular density and microvascular blood flow and increased heterogeneity during cardiopulmonary bypass. All these parameters returned to baseline values after surgery.

Graphical abstract

中文翻译：

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先天性心脏缺陷矫正手术中儿科患者微循环的变化

进行了一项前瞻性、观察性的单中心研究。接受先天性心脏缺陷手术的儿科患者在手术前、手术中和手术后进行了评估。在每个时间点，评估舌下微循环和临床参数以及分析变量。包括 24 名患者。所有微循环参数在体外循环期间恶化，并在手术后恢复到基线值 ( p ≤ 0.001)。在术中评估中，体温与灌注的小血管密度（p = 0.014）、灌注的小血管比例（p < 0.001）、小血管微血管流量指数（p = 0.003）和小血管异质性指数（p< 0.002)。紫绀病患者在基线时表现出较高的小血管密度 ( p < 0.008) 和较高的灌注小血管密度 ( p < 0.022)，在基线时表现出较低的微血管流量指数 ( p = 0.022) 和较高的异质性 ( p = 0.026)术中阶段。先天性心脏病患儿在体外循环期间表现出血管密度和微血管血流减少以及异质性增加。所有这些参数在手术后恢复到基线值。

图形概要