Skip to main content

Dynamics of peripheral perfusion parameters in elective coronary artery bypass graft patients


Recent studies have suggested that microvascular perfusion impairment may play a role in the development of postoperative organ dysfunction in patients undergoing high-risk or cardiac surgery [1, 2]. Postoperative monitoring of tissue perfusion parameters could therefore be used for early detection of tissue hypoperfusion and serve as an endpoint for resuscitation. For this purpose we measured regional and microvascular perfusion parameters in relation to systemic hemodynamics in patients undergoing open heart surgery.


We observed 10 consecutive patients who underwent elective coronary artery bypass grafting with cardiopulmonary bypass during the immediate postoperative resuscitation in the ICU. Tissue perfusion was measured directly after admission and repeated before detubation, and consisted of sublingual SDF imaging, forearm Tskin-diff, finger peripheral perfusion index, finger capillary refill time (CRT) and thenar tissue oxygenation (StO2). Cardiac output was measured with NICOM bioreactance.


CO (4.33 ± 1.63 vs. 5.37 ± 1.29) (P < 0.05) and central temperature (35.30 ± 0.24 vs. 36.56 ± 0.13) (P < 0.01) increased significantly. All tissue perfusion parameters (that is, SDF parameters (MFI ≥2.5; PPV ≥95%), StO2 ≥80%, CRT ≥5 seconds, Tskin-diff ≤3 and PFI ≥1.4) were within the normal range at admission and did not change significantly until detubation. Even the central-to-toe temperature difference showed no significant difference or correlation between cardiac output and any other peripheral tissue perfusion parameter. The postoperative course was uncomplicated in all patients.


In the postoperative period, peripheral and microvascular tissue perfusion parameters are not impaired in our CABG patients. Although from a small population, these data suggest that these parameters are not suitable for routine use as an extra hemodynamic resuscitation endpoint. This is in contrast with previous studies and might be explained by differences in study population or measurement interval.


  1. De Backer D, Dubois MJ, Schmartz D, et al.: Microcirculatory alterations in cardiac surgery: effects of cardiopulmonary bypass and anesthesia. Ann Thorac Surg 2009, 88: 1396-1403.

    Article  PubMed  Google Scholar 

  2. Jhanji S, Lee C, Watson D, et al.: Microvascular flow and tissue oxygenation after major abdominal surgery: association with postoperative complications. Intensive Care Med 2009, 35: 671-677.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Van Genderen, M., Boszhuizen, J., Lima, A.P. et al. Dynamics of peripheral perfusion parameters in elective coronary artery bypass graft patients. Crit Care 15 (Suppl 1), P77 (2011).

Download citation

  • Published:

  • DOI:


  • Perfusion Parameter
  • Coronary Artery Bypass Graft Patient
  • Microvascular Perfusion
  • Peripheral Perfusion
  • Capillary Refill Time