Abstract
Purpose
To assess and compare the effects of normothermic and mild hypothermic cardiopulmonary bypass (CPB) on hepatosplanchnic oxygenation.
Methods
We studied 14 patients scheduled for elective coronary artery bypass graft surgery who underwent normothermic (> 35°C; group I,n = 7) or mild hypothermie (32°C; group II,n = 7) CPB. After induction of anesthesia, a hepatic venous catheter was inserted into the right hepatic vein to monitor hepatic venous oxygen saturation (ShvO2) and hepatosplanchnic blood flow by a constant infusion technique that uses indocyanine green.
Results
The ShvO2 decreased from a baseline value in both groups during CPB and was significantly lower at ten minutes and 60 min after the onset of CPB in group I (39.5 ± 16.2% and 40.1 ± 9.8%, respectively) than in group II (61.1 ± 16.2% and 6.0 ±17.9%, respectively;P < 0.05). During CPB, the hepatosplanchnic oxygen extraction ratio was significantly higher in group I than in group II (44.0 ± 7.2%vs 28.7 ±13.1%;P < 0.05).
Conclusion
Hepatosplanchnic oxygenation was better preserved during mild hypothermie CPB than during normothermic CPB.
Résumé
Objectif
Évaluer et comparer les effets de la circulation extracorporelle (CEC), sous normothermie ou hypothermie légère, sur l’oxygénation hépatosplanchnlque.
Méthode
Nous avons étudié 14 patients devant subir un pontage aortocoronarien avec CEC sous normothermie (> 35 °C; groupe I, n = 7) ou hypothermie légère (32 °C; groupe II, n = 7). Après l’induction de l’anesthésle, un cathéter a été inséré dans la veine hépatique droite pour permettre de vérifier la saturation en oxygène du sang veineux hépatique (SO2vh) et le débit sanguin hépatosplanchnlque par une perfusion constante utilisant le vert d’indocyanlne.
Résultats
La SO2vh a diminué de sa valeur de base dans les deux groupes et a été significativement plus basse à 10 minutes et à 60 min après le début de la CEC dans le groupe I (39,5 ± 16,2 % et 40,1 ± 9,8 %, respectivement) que dans le groupe II (61,1 ± 16,2 % et 61,0 ± 17,9 %, respectivement; P < 0,05). Le taux déxtraction d’oxygène hépatosplanchnlque pendant la CEC a été significativement plus élevé dans le groupe I que dans le groupe II (44,0 ± 7,2 % vs 28,7 ± 13,1 %; P < 0,05).
Conclusion
Loxygénation hépatosplanchnlque a été mieux préservée pendant la CEC sous hypothermie légère que sous normothermie.
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Okano, N., Hiraoka, H., Owada, R. et al. Hepatosplanchnic oxygenation is better preserved during mild hypothermic than during normothermic cardiopulmonary bypass. Can J Anaesth 48, 1011–1014 (2001). https://doi.org/10.1007/BF03016592
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DOI: https://doi.org/10.1007/BF03016592