Splanchnic oxygen transport and lactate metabolism during normothermic cardiopulmonary bypass in humans

Anesthesia and Analgesia
M HaisjacklW Kox

Abstract

The effect of normothermic (36.2 degrees C +/- 0.6 degree C) nonpulsatile cardiopulmonary bypass (CPB) on splanchnic (hepatic) blood flow (SBF), splanchnic oxygen transport (DO2spl) and oxygen consumption (VO2spl), splanchnic lactate uptake and gastric mucosal pH (pHi, gastric tonometry) was studied in 12 adults (New York Heart Association class II, ejection fraction > or = 0.4) undergoing coronary artery surgery. SBF was estimated with the constant-infusion indocyanine green (ICG) technique using a hepatic venous catheter. DO2spl, VO2spl, and splanchnic lactate uptake were calculated using the Fick principle after the induction of anesthesia, during aortic cross-clamping, after CPB, and 2 and 7 h after admission to the intensive care unit (ICU). SBF, DO2spl, and VO2spl did not decrease during CPB but increased after ICU admission, whereas pHi decreased 7 h after ICU admission. Initial ICG extraction was 0.78, which decreased to 0.54 during aortic clamping and remained low thereafter. The increased arterial blood lactate concentrations were not associated with a decreased splanchnic lactate uptake. We conclude that normothermic CPB is not associated with deterioration in the global intestinal oxygen supply. The increase of bloo...Continue Reading

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Citations

Nov 8, 2001·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·N OkanoT Morita
Nov 25, 2011·Journal of Anesthesia·Alexander KoganEhud Raanani
Feb 21, 2002·Journal of Cardiothoracic and Vascular Anesthesia·Richard I Hall
Jun 20, 2002·Journal of Cardiothoracic and Vascular Anesthesia·Michael GårdebäckJohn Wahren
Oct 1, 2009·Journal of Cardiothoracic and Vascular Anesthesia·Sung Jason ChiMichael H Wall
Sep 18, 2004·Journal of Clinical Anesthesia·Petar MarkoLawrence J Caruso
Oct 15, 2013·Journal of Cardiothoracic and Vascular Anesthesia·Jörn Karhausen, Mark Stafford-Smith
Apr 18, 2009·Anesthesia and Analgesia·Glenn S MurphyRobert C Groom
Jul 5, 2011·Journal of Biomedical Optics·Avraham MayevskyEran Segal

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