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

Document Type : Review Articles

Authors

¹ Resident of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Zagazig University

² Assistant Professor of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Zagazig University

³ Professor of Anesthesia, Intensive Care and Pain Management, Faculty of Medicine - Zagazig University

10.21608/zumj.2025.379171.3927

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.

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