Monitoring and Management of Tissue Perfusion After Cardiopulmonary Bypass

Mostafa, Mostafa Adel; Elnakera, Abeer Mohamed; Salah, Amal Abdelazim; Gaafar, Tarek Youssif

doi:10.21608/zumj.2025.379171.3927

	Monitoring and Management of Tissue Perfusion After Cardiopulmonary Bypass
Zagazig University Medical Journal
Volume 31, Issue 7, July 2025, Page 2859-2867 PDF (1017.74 K)
Document Type: Review Articles
DOI: 10.21608/zumj.2025.379171.3927
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Authors
Mostafa Adel Mostafa ¹; Abeer Mohamed Elnakera²; Amal Abdelazim Salah³; Tarek Youssif Gaafar³
¹Resident of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Zagazig University
²Assistant Professor of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Zagazig University
³Professor of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Zagazig University
Abstract
Background: Management of tissue perfusion after cardiopulmonary bypass is one of the most critical challenges for anesthesiologists and intensivists. Even after restoring circulation and oxygenation, many patients still suffer from impaired tissue perfusion, which may lead to organ dysfunction or failure if not recognized and managed properly. Understanding the interplay between cardiac output, oxygen delivery, and systemic vascular tone is essential for guiding proper intervention. This review aims to explore pathophysiology, monitoring techniques, and evidence-based management options for hypoperfusion after CPB, highlighting practical strategies that can improve early detection and targeted intervention. Conclusion: Post-CPB hypoperfusion is a critical concern that demands early recognition and tailored management. Integrating markers like lactate, ScvO₂, and Pv-aCO₂ helps guide timely interventions. Echocardiography and hemodynamic monitoring are vital tools for assessing cardiac function. Mechanical support devices serve as effective bridges when used judiciously. Ultimately, individualized strategies focused on restoring adequate perfusion improve outcomes and reduce postoperative complications.
Keywords
Hemodynamic Monitoring; Perfusion; Cardiopulmonary Bypass


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