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4 - Microcirculation and Mitochondrial Dysfunction
from Section 1 - Hemodynamic Monitoring in the Perioperative Period
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Edited by Alexandre Joosten, University of California, Los Angeles, Maxime Cannesson, University of California, Los Angeles, Robert G. Hahn, Karolinska Institutet, Stockholm
Book:

Hemodynamic Monitoring and Fluid Therapy during Surgery

Published online:

11 April 2024

Print publication:

02 May 2024, pp 49-56
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Summary

Organ dysfunction often occurs in the perioperative setting and in sepsis. Alterations in systemic hemodynamics may play a role, but even when these are within therapeutic goals, organ dysfunction may still occur. Microcirculatory alterations, a key determinant of tissue perfusion and of mitochondrial dysfunction, may play a role in the development of organ dysfunction. In this chapter, we discuss the evidence for alterations in microcirculatory and mitochondrial functions and their relevance, in circulatory failure and in the perioperative setting.

Combination of veno-arterial extracorporeal membrane oxygenation and hypothermia for out-of-hospital cardiac arrest due to Taxus intoxication
Aurélie Thooft, Ahmed Goubella, David Fagnoul, Fabio S. Taccone, Serge Brimioulle, Jean-Louis Vincent, Daniel De Backer
Journal:

Canadian Journal of Emergency Medicine / Volume 16 / Issue 6 / November 2014

Published online by Cambridge University Press:

04 March 2015, pp. 504-507

Print publication:

November 2014
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A young woman presented with cardiac arrest following ingestion of yew tree leaves of the Taxus baccata species. The toxin in yew tree leaves has negative inotropic and dromotropic effects. The patient had a cardiac rhythm that alternated between pulseless electrical activity with a prolonged QRS interval and ventricular fibrillation. When standard resuscitation therapy including digoxin immune Fab was ineffective, a combination of extracorporeal membrane oxygenation (ECMO) and hypothermia was initiated. The total duration of low flow/no flow was 82 minutes prior to the initiation of ECMO. After 36 hours of ECMO (including 12 hours of electrical asystole), the patient’s electrocardiogram had normalized and the left ventricular ejection fraction was 50%. At this time, dobutamine and the ECMO were stopped. The patient had a full neurologic recovery and was discharged from the intensive care unit after 5 days and from the hospital 1 week later.

Chapter 8 - Microcirculation and mitochondrial dysfunction
from Section 2 - Cardiovascular Physiology Applied to the Perioperative and Critical Care Settings
- By Daniel De Backer, Diego Orbegozo Cortes
Edited by Maxime Cannesson, University of California, Irvine, Rupert Pearse
Book:

Perioperative Hemodynamic Monitoring and Goal Directed Therapy

Published online:

05 September 2014

Print publication:

04 September 2014, pp 56-61
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