Cutaneous microcirculation and blood rheology following cardiopulmonary bypass. Laser Doppler flowmetric and blood cell rheologic studies.

In 23 patients undergoing coronary artery bypass grafting, measurements of cutaneous blood flow were made with laser doppler flowmetry. Simultaneously blood was sampled for measurement of red cell filtration rate (RFR) and plasma-white cell filtration rate (P-WFR). The cutaneous blood flow showed significant overall reduction postoperatively. When the saphenous vein or internal mammary artery was used as bypass graft, the reduction in skin blood flow at the sites from which the vessels were taken was significantly greater than in contralateral, undisturbed sites. RFR and P-WFR were also significantly reduced postoperatively, and these changes showed significant concomitance with the fall in laser doppler flow (LDF%). On postoperative day 6 there was some improvement in LDF% and RFR but further slight deterioration in P-WFR. The study indicated that surgical trauma locally reduces cutaneous blood flow and that trauma to blood cells following cardiopulmonary bypass can contribute to this reduction.