Minerva anestesiologica
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Minerva anestesiologica · Jan 2012
Editorial CommentOff-pump coronary surgery: is it just a surgical matter?
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Minerva anestesiologica · Jan 2012
Comparative StudyDo on- and off-pump coronary bypass surgery differently affect perioperative peripheral tissue metabolism?
Microdialysis allows the in-vivo assessment of interstitial fluids. We studied the metabolic status of peripheral tissues (skeletal muscle) in patients undergoing coronary artery bypass surgery on- (CABG) or off-pump (OPCAB). ⋯ Metabolic changes after coronary bypass surgery occur with some differences related to CPB use. Overall, these changes suggest that, after coronary surgery, a certain degree of hypermetabolic state ensues, lasting up to 24 hours after surgery; the postoperative increase in pyruvate levels in CABG patients, together with the changes in L/P ratio occurring only in OPCAB patients implies an higher risk of tissue hypoperfusion/ischemia for patients submitted to OPCAB, although this does not lead to permanent cellular damage, as the markers of this complication (e.g., glycerol) do not change over time.