Warming during cardiopulmonary bypass is associated with jugular bulb desaturation.
Warming during cardiopulmonary bypass is associated with jugular bulb desaturation.
复制标题
体外循环期间的变暖与颈静脉球去饱和度有关。
DOI：
10.1016/0003-4975(92)91445-f
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Reves,JG
中科院分区：
文献类型：
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作者：
Croughwell,ND;Frasco,P;Blumenthal,JA;Leone,BJ;White,WD;Reves,JG
本研究的目的是描述常温非搏动体外循环期间脑静脉流出液的特征。133例患者中有31例（23%）在常温心肺转流期间（27 °至28 °C低温心肺转流后）符合去饱和标准（定义为颈静脉球静脉血氧饱和度≤ 50%或颈静脉球静脉氧分压≤ 25 mm Hg）。采用氙133清除方法计算的脑血流量，（p< 0.005）饱和组较高（33.7 ± 10.3 mL · 100 g−1· min−1），明显高于去饱和组（26.2 ± 6.9 mL · 100 g−1· min−1），而脑氧代谢率则显著降低在常温下，饱和组（1.28 ± 0.39 mL · 100 g−1· min−1）比去饱和组（1.52 ± 0.36 mL · 100 g −1·min − 1）（p< 0.005）。常温下，饱和组的动静脉氧差（3.92 ± 1.12 mL/dL）低于去饱和组（5.97 ± 1.05 mL/dL）。在术前和术后第7天对133例患者中的74例进行神经心理学测试。两组术后所有测试的平均评分普遍下降，两组之间无显著差异。我们的结论是，脑静脉去饱和代表了一个全球性的脑氧供需失衡，发生在常温体外循环，并可能代表短暂的脑缺血。然而，与没有去饱和证据的患者的表现相比，这些发作与即时神经心理学测试表现无关。
The objective of this study was to characterize cerebral venous effluent during normothermic nonpulsatile cardiopulmonary bypass. Thirty-one (23%) of 133 patients met desaturation criteria (defined as jugular bulb venous oxygen saturation ≤ 50% or jugular bulb venous oxygen tension ≤ 25 mm Hg) during normothermic cardiopulmonary bypass (after hypothermic cardiopulmonary bypass at 27 ° to 28 °C). Cerebral blood flow, calculated using xenon 133 clearance methodology, was significantly (p< 0.005) higher in the saturated group (33.7 ± 10.3 mL · 100 g−1· min−1) than in the desaturated group (26.2 ± 6.9 mL · 100 g−1· min−1), whereas the cerebral metabolic rate for oxygen was significantly lower (p< 0.005) in the saturated group (1.28 ± 0.39 mL · 100 g−1· min−1) than in the desaturated group (1.52 ± 0.36 mL · 100 g−1· min−1) at normothermia. The arteriovenous oxygen difference at normothermia was lower in the saturated group (3.92 ± 1.12 mL/dL) than in the desaturated group (5.97 ± 1.05 mL/dL). Neuropsychological testing was performed in 74 of the 133 patients preoperatively and on day 7 postoperatively. There was a general decline in mean scores of all tests postoperatively in both groups with no significant difference between the groups. We conclude that cerebral venous desaturation represents a global imbalance in cerebral oxygen supply-demand that occurs during normothermic cardiopulmonary bypass and may represent transient cerebral ischemia. These episodes, however, are not associated with impared neuropsychological test performance as compared with the performance of patients with no evidence of desaturation.