Influence of hematocrit and pump prime on cerebral oxygen saturation in on-pump coronary revascularization
Influence of hematocrit and pump prime on cerebral oxygen saturation in on-pump coronary revascularization
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DOI：
10.1191/0267659106pf863oa
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发表时间：
2006-01-01
期刊：
影响因子：
1.2
通讯作者：
Vijay, V
中科院分区：
文献类型：
--
作者：
McCusker, K;Chalafant, A;Vijay, V
背景：本研究探讨了脑氧合 (rSO(2))、体外循环血细胞比容和回路启动之间的耦合。方法：连续 38 名接受体外循环 (CPB) 冠状动脉血运重建的患者在术前血细胞比容 < 40% 和 > 40% 上进行匹配 (n = 16)。同样，六名血液初始患者与六名晶体初始患者相匹配。然后比较 CPB 时的血细胞比容和 rSO(2) 水平。结果：术前血细胞比容 > 40% 组在泵运行时保持较高水平 (p < 0.01)，并且在 CPB 前 (64.8 +/- 9.6 与 73.2 +/- 7.3) 以及 CPB 期间和停药时 (61.1 +/- 8.8 与 67.4 +/- 6.4) 保持较高水平的 rSO(2)。在低血细胞比容组中，血液预充增加了绝对rSO(2)（2.3 +/- 6.3 对比-10.9 +/- 5.9）和% rSO(2)（4.7 +/- 11.8 对比-14.2 +/- 7.4%）。结论：血液预充对于高危和低术前血细胞比容患者在 CPB 开始和维持期间预防脑氧饱和度下降很有帮助。
Background: The couplings between cerebral oxygenation (rSO(2)), on-pump hematocrit and circuit prime are explored in this study. Methods: Thirty-eight consecutive patients undergoing coronary revascularization with cardiopulmonary bypass (CPB) were matched on preoperative hematocrit < 40% and > 40% (n = 16). Similarly, six blood prime patients were matched with six crystalloid prime patients. Hematocrit and rSO(2) levels were then compared on CPB. Results: The preoperative hematocrit > 40% group retained higher levels on pump run (p < 0.01) and significantly higher rSO(2) prior to CPB (64.8 +/- 9.6 versus 73.2 +/- 7.3), and on and off CPB (61.1 +/- 8.8 versus 67.4 +/- 6.4). Blood priming increased absolute rSO(2) (2.3 +/- 6.3 versus -10.9 +/- 5.9) and % rSO(2) (4.7 +/- 11.8 versus -14.2 +/- 7.4%) in the low hematocrit group. Conclusion: Blood primes are instrumental in high-risk and low preoperative hematocrit patients in preventing cerebral oxygen desaturation during initiation and maintenance of CPB.