An analysis of oxygen consumption and oxygen delivery in euthermic infants after cardiopulmonary bypass with modified ultrafiltration
An analysis of oxygen consumption and oxygen delivery in euthermic infants after cardiopulmonary bypass with modified ultrafiltration
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DOI：
10.1016/j.athoracsur.2004.02.032
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发表时间：
2004-10-01
影响因子：
4.6
通讯作者：
Redington, AN
中科院分区：
文献类型：
--
作者：
Li, J;Hoschtitzky, A;Redington, AN
背景。体外循环（CPB）后全身耗氧量（VO2）和输送量（DO2）之间的平衡受到损害，并且与全身炎症反应综合征有关。我们试图在婴儿体外循环后使用改良超滤 (MUF) 来评估 VO2 和 DO2 及其与促炎细胞因子的关系。方法。研究人员对 16 名年龄在 1-11.5 个月（中位数为 6.3 个月）的婴儿在到达重症监护病房 (ICU) 后的前 12 小时内接受 MUF 低温 CPB 进行了研究。使用外部冷却或加温将中心温度维持在36.8-37.1℃。使用呼吸质谱法连续测量 VO2。到达 ICU 时以及术后 2、4、8 和 12 小时采集动脉血样本检测肿瘤坏死因子 (TNF)、白细胞介素 6 (IL-6) 和白细胞介素 8 (IL-8)，并使用 Fick 原理计算 DO2。在麻醉诱导后和 MUF 结束时另外测量细胞因子。结果。研究期间摄氧量显着下降 18.8%。 DO2 在此期间一直下降，并在 8 小时时达到最低点（357.1 +/- 136.2 ml (.) min(-1) (.) m(-2)）。尽管每种细胞因子的水平与摄氧量测量值之间存在不同的关系，但细胞因子的减少伴随着摄氧量的减少。结论。我们的数据表明，婴儿 CPB 后前 12 小时内摄氧量出现异常持续下降。除了使用MUF外，控制体温以维持体温可能有利于术后早期VO2和DO2的平衡。 (C) 2004 年，胸外科医师协会。
Background. The balance between systemic oxygen consumption (VO2) anddelivery (DO2) is impaired after cardiopulmonary bypass (CPB) and is related to systemic inflammatory response syndrome. We sought to assess VO2 and DO2 and their relationship with proinflammatory cytokines after CPB with the use of modified ultrafiltration (MUF) in infants.Methods. Sixteen infants, aged 1-11.5 months (median, 6.3 months), undergoing hypothermic CPB with MUF were studied during the first 12 hours after arrival in the intensive care unit (ICU). The central temperature was maintained at 36.8-37.1 degreesC using external cooling or warming. VO2 was continuously measured using respiratory mass spectrometry. Arterial blood samples for the tumor necrosis factor (TNF), interleukin-6 (IL-6), and interleukin-8 (IL-8) were taken and DO2 was calculated using the Fick principle on arrival at the ICU, and 2, 4, 8, and 12 hours postoperatively. Cytokines were additionally measured after induction of anesthesia and at the end of MUF.Results. VO2 significantly decreased by 18.8% during the study period. DO2 was depressed throughout this period and reached a nadir at 8 hours (357.1 +/- 136.2 ml (.) min(-1) (.) m(-2)). The decrease in cytokines was accompanied with the decrease in VO2 despite varied relationships between the levels of each of the cytokines and VO2 measurements.Conclusions. Our data indicate an unusual continuous decrease in VO2 during the first 12 hours after CPB in infants. Control of body temperature to maintain euthermia in addition to the use of MUF may be beneficial to the balance between VO2 and DO2 in the early postoperative period. (C) 2004 by The Society of Thoracic Surgeons.