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THE 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
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ORIGINAL ARTICLES CARDIAC SECTION
The Journal of Cardiovascular Surgery 2001 December;42(6):723-9
Effect of coronary artery bypass grafting with gastroepiploic artery on gastric intramucosal pH and systemic inflammation
Yamaura K., Akiyoshi K., Irita K., Takahashi S.
From the Department of Anesthesiology and Critical Care Medicine Graduate School of Medical Sciences Kyushu University, Fukuoka, Japan
Background. The purpose of this study was to investigate the effect of coronary arterial bypass grafting (CABG) with gastroepiploic artery (GEA) on gastric intramucosal pH and systemic inflammation.
Methods. Design: retrospective study. Setting: Univer-sity hospital. Participants: 22 patients under-went CABG. Investigations: the GEA group (n=13) received CABG with the GEA graft. The non-GEA group (n=9) received conventional CABG without the GEA graft. Measurements: gastric intramucosal pH (pHi) and carbon dioxide tension (PrCO2) were assessed by capnometric air tonometry. The difference between PrCO2 and PaCO2, PCO2-gap, was also determined. Systemic inflammatory responses were evaluated by serum interleukin-6 (IL-6) and leucocyte counts. Hemodynamics, oxygen delivery index (D˙O2I) and uptake index (V˙O2I) were monitored with catheters in the radial and pulmonary arteries (thermodilution).
Results. The duration of aortic cross-clamping and cardiopulmonary bypass was similar in both groups. Both groups did not show any significant difference in gastric pHi, PCO2-gap, systemic inflammation and hemodynamics.
Conclusions. Our findings suggest that CABG using the GEA graft does not disturb gastric mucosal perfusion, and that laparotomy for the GEA graft does not aggravate systemic oxygen demand-supply imbalance or systemic inflammatory responses induced by hypothermic CPB. CABG with the GEA graft does not seem to pose an additional risk and is a safe technique compared with conventional CABG with regard to pHi and systemic inflammation.