Deoxygenated blood minimizes adherence of sonicated albumin microbubbles during cardioplegic arrest and after blood reperfusion: Experimental and clinical observations with myocardial contrast echocardiography
Deoxygenated blood minimizes adherence of sonicated albumin microbubbles during cardioplegic arrest and after blood reperfusion: Experimental and clinical observations with myocardial contrast echocardiography
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DOI：
10.1016/s0022-5223(97)70297-6
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发表时间：
1997-06-01
影响因子：
6
通讯作者：
Spotnitz, WD
中科院分区：
文献类型：
--
作者：
Bayfield, MS;Lindner, JR;Spotnitz, WD
心脏停搏液灌注和血液再灌注均可导致内皮功能障碍，心肌声学造影白蛋白微泡通过率可反映内皮损伤，我们对12只接受体外循环的狗进行了心肌声学造影，并在输送含动脉和静脉的心脏停搏液时测量了注入主动脉根部的微泡的心肌通过率。在输注晶体停搏液和纯晶体停搏液的过程中，测定了99 m标记红细胞的心肌通过率，并采集灌流液进行生化分析。微泡通过率在输注晶体停搏液过程中明显延长，在输注纯晶体停搏液过程中明显提高（p < 0.001）;静脉血与动脉血相比，（p < 0.001），微泡通过率与pH、氧张力或二氧化碳张力值或K+浓度无关，无论输注何种心脏停搏灌注液，红细胞通过率均保持恒定，对12例冠状动脉搭桥术患者进行了心肌声学造影，这些患者在术后接受了动脉和静脉再灌注，静脉血再灌注的微泡通过速率比动脉血再灌注的快（p = 0.01），尽管当动脉血再灌注先于静脉血再灌注时，这种增益减小（p = 0.05）。我们的研究结果表明，心脏停搏后的内皮功能障碍可能会改善再灌注静脉血，而不是动脉血。
Both administration of cardioplegic solution and blood reperfusion result in endothelial dysfunction, The transit rate of albumin microbubbles during myocardial contrast echocardiography may reflect endothelial injury, Accordingly, we performed myocardial contrast echocardiography in 12 dogs undergoing cardiopulmonary bypass and measured the myocardial transit rate of microbubbles injected into the aortic root during delivery of cardioplegic solutions containing arterial and venous blood and delivery of pure crystalloid cardioplegic solution, The myocardial transit rate of Tc-99m-labeled red blood cells was measured and perfusates were sampled for biochemical analysis at each stage, The microbubble transit rate was markedly prolonged during delivery of crystalloid cardioplegic solution and improved significantly during infusion of blood cardioplegic solution (p < 0.001); venous compared with arterial blood in the solution resulted in a greater rate (p < 0.001), The microbubble transit rate did not correlate with pH, oxygen tension or carbon dioxide tension values, or K+ concentration, The red blood cell transit rate remained constant regardless of the cardioplegic perfusate infused, Myocardial contrast echocardiography was also performed in 12 patients undergoing coronary artery bypass who underwent sequential arterial and venous reperfusion after cardioplegic arrest, The microbubble transit rate was faster with venous than arterial blood reperfusion (p = 0.01), although this gain was diminished when arterial blood reperfusion preceded venous blood reperfusion (p = 0,05). Our results indicate that endothelial dysfunction after cardioplegic arrest may be ameliorated by reperfusion with venous rather than arterial blood.