Effect of perfusion flow rate on tissue oxygenation in newborn piglets during cardiopulmonary bypass.
Effect of perfusion flow rate on tissue oxygenation in newborn piglets during cardiopulmonary bypass.
复制标题
体外循环期间灌注流量对新生仔猪组织氧合的影响。
DOI：
10.1016/s0003-4975(02)04342-4
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发表时间：
2003
期刊：
影响因子：
--
通讯作者：
Pastuszko,Anna
中科院分区：
文献类型：
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作者：
Schears,Gregory;Schultz,StevenE;Creed,Jennifer;Greeley,WilliamJ;Wilson,DavidF;Pastuszko,Anna
背景：关于体外循环(CPB)中维持组织氧合的最佳灌流速度的知识仍不完全。本研究探讨了常温体外循环中灌流流量和动脉导管未闭对新生仔猪几个器官组织氧合的影响。方法12头新生仔猪，6头结扎动脉导管，6头不结扎动脉导管。体外循环期间，流量每隔15分钟改变一次，范围为100~250ml/kg/min。用磷光猝灭法测定组织氧合。结果PDA-L组大鼠脑组织氧含量无明显变化。相反，对于PDA-NL组，氧气依赖于流速。当流速低于175ml/kg/min时，皮质氧含量显著降低。在心肌、肝脏和肠道内，PDA-L组和PDA-NL组之间的氧水平没有显著差异。在这些组织中，当流量分别低于150ml/kg/min、125ml/kg/min和175ml/kg/min时，氧气显著减少。骨骼肌氧分压不受PDA结扎和流速的影响。结论在新生猪体外循环中，PDA的存在会降低组织对脑的氧合，但不会降低对其他器官的氧合。一般来说，为了维持除肌肉以外的所有器官的正常氧合，灌流流率需要达到或超过175毫升/公斤/分钟。
BACKGROUNDOur knowledge of the best perfusion flow rate to use during cardiopulmonary bypass (CPB) in order to maintain tissue oxygenation remains incomplete. The present study examined the effects of perfusion flow rate and patent ductus arteriosus (PDA) during normothermic CPB on oxygenation in several organ tissues of newborn piglets.METHODSThe experiments were performed on 12 newborn piglets: 6 with PDA ligation (PDA-L), and 6 without PDA ligation (PDA-NL). CPB was performed through the chest at 37°C. During CPB, the flow rate was changed at 15-minute intervals, ranging from 100 to 250 ml/kg/min. Tissue oxygenation was measured by quenching of phosphorescence.RESULTSFor the PDA-L group, oxygen in the brain did not change significantly with changes in flow rate. In contrast, for the PDA-NL group, oxygen was dependent upon the flow rate. Statistically significant decreases in cortical oxygen were observed with flow rates below 175 ml/kg/min. Within the myocardium, liver, and intestine, there were no significant differences in the oxygen levels between the PDA-L and PDA-NL groups. In these tissues, the oxygen decreased significantly as the flow rate decreased below 150 ml/kg/min, 125 ml/kg/min, and 175 ml/kg/min, respectively. Oxygen pressure in skeletal muscle was not dependent on either PDA ligation or flow rate.CONCLUSIONSIn newborn piglets undergoing CPB, the presence of a PDA results in reduced tissue oxygenation to the brain but not to other organs. In general, perfusion flow rates of 175 ml/kg/min or greater are required in order to maintain normal oxygenation of all organs except muscle.