Normal and abnormal trans-oxygenator pressure gradients during cardiopulmonary bypass
Normal and abnormal trans-oxygenator pressure gradients during cardiopulmonary bypass
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DOI：
10.1191/0267659103pf635oa
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发表时间：
2003-01-01
期刊：
影响因子：
1.2
通讯作者：
Whitehorne, M
中科院分区：
文献类型：
--
作者：
Fisher, AR;Baker, M;Whitehorne, M
进行了一项前瞻性研究，目的是1)确定一系列氧合器的正常反式氧合器压力梯度特征，2)确定异常升高的梯度的特征、发生率和结局。对8家不同医院的3684例心内直视手术患者的反式氧合器压力梯度进行了监测。在毫米汞柱/L血流的体外循环中测量正常压力梯度时，得到了一个恒定的图，该图是针对每个氧合器的。此梯度异常升高16例(每230例中有1例)，其中3例升高到需要紧急更换氧合器的程度(每1228例中有1例)。在报告的16起事件中，发生了三种不同的梯度变化模式，这表明可能存在三种不同的病因。在其中9例中，压力梯度在搭桥后立即正常，但迅速上升到平台值，然后在40分钟内恢复到正常值。在三种情况下，压力梯度在转流后立即升高，然后迅速恢复到基线水平。在一例中，压力梯度在接受搭桥手术后立即升高，并在整个手术过程中保持升高。
A prospective study was conducted with the aims of 1) determining the normal trans-oxygenator pressure gradient characteristics for a range of oxygenators and 2) determining the characteristics, incidence and outcome of abnormally raised gradients. The trans-oxygenator pressure gradient was monitored in 3684 patients undergoing open-heart surgery in eight different hospitals. When the normal pressure gradient was measured during cardiopulmonary bypass in mmHg/L blood flow, a constant figure was obtained which was specific for each oxygenator. This gradient was abnormally raised in 16 cases (one in every 230 cases) and was raised to such an extent in three of these cases that an emergency oxygenator changeout was required (one in every 1228 cases). Among the 16 reported incidents, three different patterns of gradient changes occurred, suggesting the possibility that there were three different aetiologies. In nine of these incidents, the pressure gradient was normal immediately upon going on bypass, but rose rapidly to a plateau value, which then returned to the normal value within 40 minutes. In three cases, the pressure gradient was raised immediately upon going on bypass and then rapidly returned to the baseline. In one case, the pressure gradient was raised immediately upon going on bypass and stayed raised throughout the operation.