Evaluation of Microcirculatory Function and Mitochondrial Respiration After Cardiovascular Surgery

The MicroRESUS Study: An Observational Study to Examine the Effects of Circulatory Shock and Resuscitation on Microcirculatory Function and Mitochondrial Respiration After Cardiovascular Surgery.

This study will examine the differences in microcirculatory function and mitochondrial respiration in patients with shock after cardiovascular surgery.

Post-cardiotomy shock (PCS) occurs in up to 5% of cardiovascular surgeries and has an in-hospital mortality rate as high as 75%. It is unclear if patients with PCS despite achieving standard resuscitation goals have impairments in oxygen delivery or oxygen utilization. This study will examine the difference in microcirculatory function and mitochondrial respiration in patients with shock to better understand the driving mechanism of bioenergetic failure in patients with PCS.

Inclusion Criteria:

• Adult patients (>18 years old)
• Receiving elective coronary artery bypass graft (CABG)
• Receiving valvular surgery requiring cardiopulmonary bypass

Exclusion Criteria:

• Unable to tolerate sublingual microcirculatory flow imaging (e.g., non-intubated patients dependent upon oxygen by facemask, poor mouth opening)
• receiving an emergent procedure
• have an actively treated malignancy
• mitochondrial disorder
• receiving surgery requiring deep hypothermic circulatory arrest.