TITLE

The oxygen debt during routine cardiac surgery: illusion or reality?

AUTHOR(S)
Ganushchak, YM; Maessen, JG; de Jong, DS
PUB. DATE
May 2002
SOURCE
Perfusion;May2002, Vol. 17 Issue 3, p167
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Patients undergoing cardiac surgery with the use of cardiopulmonary bypass (CPB) are often thought to have tissue hypoxia and intraoperative oxygen debt accumulation despite the lack of sufficient data to support this assumption. Methods and results: Oxygen uptake and related parameters, including the plasma lactate and pyruvate concentrations, were studied during the perioperative period in a group of 15 consecutive patients who underwent coronary artery bypass graft surgery. The actual oxygen uptake (VO[sub 2]) and delivery (DO[sub 2]) were compared with the individual expected (computed) oxygen transport values. The mean values of DO[sub 2] and VO[sub 2] were in the range of the expected values. Our results demonstrate a leading role for body temperature in perioperative changes of oxygen consumption rate (r[sup 2] = 0.65, p < 0.001). Plasma lactate and pyruvate did not exceed the physiological range in any patient. However, with initiation of CPB, the lactate to pyruvate (LA/PVA) ratio increased (from 9.87±2.43 at T1 to 12.08 ± 1.51 at T2, p < 0.05). The mean value of the LA/ PVA ratio was elevated during surgery. Later, upon lowering of the plasma lactate concentration in the postoperative period, the LA/PVA ratio decreased to normal values. Without any other evidence of hypoxia, this increase in the LA/PVA ratio could be explained by washout of lactate from previously hypoperfused tissues and intraoperative decrease of lactate clearance. Conclusion: Systemic oxygenation was not impaired during CPB, or during 18 h after surgery in the studied group of patients.
ACCESSION #
6747073

 

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics