Effect of temperature during cardiopulmonary bypass on gastric mucosal perfusion.
Effect of temperature during cardiopulmonary bypass on gastric mucosal perfusion.
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体外循环期间温度对胃粘膜灌注的影响。
DOI：
10.1093/bja/78.1.34
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发表时间：
1997
影响因子：
9.8
通讯作者：
Mythen,MG
中科院分区：
文献类型：
--
作者：
Croughwell,ND;Newman,MF;Lowry,E;DavisJr,RD;Landolfo,KP;White,WD;Kirchner,JL;Mythen,MG
我们研究的目的是前瞻性地研究低温和不温体外循环(CPB)对内脏反应的影响，方法是通过对动脉血气的恒定控制。24例择期冠状动脉搭桥术患者被随机分配到不温(35-36摄氏度)或低温(30摄氏度)搭桥组。分4次测量：(1)基线，(2)CPB期间稳定(流入体温=鼻咽温度)，30℃，转流+20min，转流结束前10min，转流结束后，缝合皮肤。两组患者术后第1~4天胃粘膜内pH值(PHim)均显著降低，第4时温冷组与温冷组之间低pH值发生率差异无统计学意义(4/12 vs 3/12；ns)，第3时温热组胃黏膜内pH值显著低于温热组(P=0.03)，但这种差异可能是由于冷冻组pH偏高所致。PH值低的患者术后非心脏并发症发生率明显高于低pH值患者(P=0.0008)。因此，我们得出结论，尽管CPB期间的温度对PHIM有短暂的影响，但它不太可能是转流后肠粘膜低灌注率的主要决定因素。
The purpose of our study was to prospectively study the splanchnic response to hypothermic and tepid cardiopulmonary bypass (CPB) using alphastat management of arterial blood-gas tensions. Twenty-four patients for elective CABG surgery were allocated randomly to tepid (35-36 degrees C) or hypothermic (30 degrees C) bypass groups. Measurements were made at four times: (1) baseline, (2) stable during CPB (inflow temperature = nasopharyngeal temperature) 30 degrees C for hypothermic patients, bypass +20 min for tepid patients, (3) 10 min before the end of bypass, (4) after bypass, skin closure. Both groups demonstrated a significant reduction in gastric intramucosal pH (pHim) from time 1 to time 4 and there was no difference in the incidence of a low pHim between the tepid and cold groups (4/12 vs 3/12; ns) at time 4. pHim was significantly lower in the tepid groups at time 3 (P = 0.03) but this discrepancy may have been because of an artefactually high pHim in the cold group. There was a significantly higher incidence of postoperative non-cardiac complications in patients who had a low pHim at time 4 (P = 0.0008). Therefore, we conclude that although the temperature during CPB had a transient effect on pHim it is unlikely to be a major determinant in the pathogenesis of gut mucosal hypoperfusion after bypass.
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影响因子：
37.8
作者：
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影响因子：
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影响因子：
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作者：
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影响因子：
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作者：
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通讯作者：
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影响因子：
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