Ricerca avanzata

Home > Riviste > The Journal of Cardiovascular Surgery > Fascicoli precedenti > The Journal of Cardiovascular Surgery 1998 Ottobre;39(5) > The Journal of Cardiovascular Surgery 1998 Ottobre;39(5):593-7

FASCICOLI E ARTICOLI   I PIÙ LETTI   eTOC

ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica

Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,632

Periodicità: Bimestrale

ISSN 0021-9509

Online ISSN 1827-191X

 

The Journal of Cardiovascular Surgery 1998 Ottobre;39(5):593-7

CARDIAC PAPERS 

 ORIGINAL ARTICLES

Ischemic ­threshold ­during ­cold ­blood car­di­o­plegic ­arrest: mon­i­toring ­with ­tissue pH and pO2

Carrier M., Trudelle S., Thai P., Pelletier L.

From the Car­di­o­vas­cular Divi­sion Mon­treal ­Heart Insti­tute, Mon­treal, QC, (Canada

Back­ground. Sev­eral ­studies ­have sug­gested ­that meas­uring inter­sti­tial pH and pO2, may be ­useful to mon­itor ­ischemia ­throughout car­di­o­plegic ­arrest ­during car­diac sur­gery.
­Methods. To eval­uate the ­levels of myo­car­dial ­tissue pH and pO2 ­that cor­re­late ­with sig­nif­i­cant ­ischemia, 7 ­dogs under­went ­cold ­blood car­di­o­plegic ­arrest and sub­se­quent incre­mental epi­sodes of 5, 10, 20 and 40 min of ­ischemia inter­rupted by car­di­o­plegic infu­sion ­over 10-min ­periods.
­Results. Myo­car­dial ­tissue pH and pO2 ­were mon­i­tored ­with ­probes ­implanted in the ante­rior and lat­eral ­walls of the ­left ven­tricle. The ­release of CK, tro­po­nine T and lac­tate was meas­ured ­before and ­after ­each epi­sode of ­ischemic ­arrest. ­Tissue pH ­decreased ­from 7.08±0.15 to 7.03±0.15 (p>0.05), 7.21±0.15 to 7.07+0.11 (p>0.05), 7.17±0.15 to 6.82±0.14 (p<0.05) and 7.0±0.18 to 6.63±0.08 (p<0.05) ­after 5, 10, 20 and 40 min of ­ischemic ­arrest. ­Tissue pO2 ­decreased ­from 74±10 to 38±11 ­mmHg (p<0.05), 83±16 to 18±4 ­mmHg (p<0.05), 9±22 to 14±5 ­mmHg (p<0.05) and 64±24 to 16±10 ­mmHg (p<0.05) ­after 5, 10, 20 and 40 min of ­ischemic ­arrest. CK, tro­po­nine T and lac­tate ­serum ­levels ­increased sig­nif­i­cantly ­only fol­lowing 40 min of ­ischemic ­arrest. Myo­car­dial tem­per­a­ture ­decreased to an ­average min­imum of 14±1°C ­during car­di­o­plegic infu­sion.
Con­clu­sions. A myo­car­dial ­tissue pH ­lower ­than 7.04 (90% CI, ­upper ­limit of 6.82±0.14) and a ­tissue pO2 ­lower ­than 22 ­mmHg (90% CI, ­upper ­limit of 14±5 ­mmHg) cor­re­late ­with anaer­obic metab­olism and myo­car­dial ­ischemia ­during ­cold car­di­o­plegic ­arrest.

lingua: Inglese


FULL TEXT  ESTRATTI

inizio pagina