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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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ORIGINAL ARTICLES  CARDIAC SECTION


The Journal of Cardiovascular Surgery 2001 Ottobre;42(5):587-93

lingua: Inglese

Beneficial effect of balloon-induced pulsatility on brain oxygenation in hypothermic cardiopulmonary bypass

Hashimoto K., Onoguchi K., Takakura H., Sasaki T., Hachiya T., Oshiumi M., Takeuchi S.

From the Sai­tama Car­di­o­vas­cular and Res­pir­a­tory ­Center, Depart­ment of Car­di­o­vas­cular Sur­gery, Sai­tama-ken, ­Japan


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Back­ground. Suf­fi­cient O2 ­delivery to ­meet the ­demand is an impor­tant ­factor for pro­tecting the ­brain ­during car­di­o­pul­mo­nary ­bypass (CPB). ­This ­study was ­designed to inves­ti­gate the influ­ences of tem­per­a­ture, pul­sa­tility of ­blood ­flow (intra-­aortic bal­loon ­pump-­induced) and ­flow ­rate ­during CPB on the cere­bral oxy­gen­a­tion.
­Methods. ­Patients ­were ­divided ­into ­five ­groups. Nor­mo­thermia (36°C): pul­sa­tile (n=8, 2.5 L/min/m2), non­pul­sa­tile (n=12, 2.5 L), and non­pul­sa­tile per­fu­sion (n=12, 2.8 L); hypo­thermia (30°C): pul­sa­tile (n=9, 2.5 L) and non­pul­sa­tile per­fu­sion (n=11, 2.5 L). The ­oxygen sat­u­ra­tion (­SjVO2), lac­tate and CPK-BB ­levels in the jug­ular ­venous ­blood ­were meas­ured.
­Results. In all of the nor­mo­thermic ­groups, the ­SjVO2 ­value ­decreased ­during the CPB (p<0.1-0.01). No remark­able ­change was ­observed in the hypo­thermic ­groups, ­with the excep­tion ­during the ­rewarming ­period in the non­pul­sa­tile ­group. A ­higher ­SjVO2 and a ­lower fre­quency of ­SjVO2 ­values <50% ­were ­observed in the hypo­thermic pul­sa­tile ­group, as com­pared ­with ­those in the nor­mo­thermic ­groups (p<0.05). The ­levels of CPK-BB ­were ­nearly the ­same, how­ever the ­levels of lac­tate ­were ­higher in the nor­mo­thermic pul­sa­tile and non­pul­sa­tile (2.5 L) ­groups (p<0.05).
Con­clu­sions. We con­cluded ­that the hypo­thermic CPB was advan­ta­geous ­over nor­mo­thermic CPB in ­regard to the ­SjVO2 ­levels and lac­tate pro­duc­tion. The ben­e­fi­cial ­effect of intra-­aortic bal­loon ­pump ­assist was ­only ­obtained in the hypo­thermic CPB.

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