RETRACTED: The influence of allogeneic red blood cell transfusion compared with 100% oxygen ventilation on systemic oxygen transport and skeletal muscle oxygen tension after cardiac surgery (Retracted Article)

被引:44
作者
Suttner, S
Piper, SN
Kumle, B
Lang, K
Röhm, KD
Isgro, F
Boldt, J
机构
[1] Klinikum Ludwigshafen, Dept Anesthesiol & Intens Care Med, D-67063 Ludwigshafen, Germany
[2] Klinikum Ludwigshafen, Dept Cardiac Surg, D-67063 Ludwigshafen, Germany
关键词
D O I
10.1213/01.ANE.0000120163.44315.47
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
In this study we investigated the effects of allogeneic red blood cell (RBC) transfusion on tissue oxygenation compared with those of 100% oxygen ventilation by using systemic oxygen transport variables and skeletal muscle oxygen tension (P(ti)o(2)). Fifty-one volume-resuscitated, mechanically ventilated patients with a nadir hemoglobin concentration in the range from 7.5 to 8.5 g/dL after elective coronary artery bypass grafting were allocated randomly to receive 1 unit (transfusion 1; n = 17) or 2 units (transfusion 2; n = 17) of allogeneic RBCs and ventilation with 40% oxygen or pure oxygen ventilation (100% oxygen; n = 17) and no allogeneic blood for 3 hours. Invasive arterial and pulmonary artery pressures and calculations of oxygen delivery (oxygen delivery index) and consumption indices (oxygen consumption index) were documented at 30-min intervals. P(ti)o(2) was measured continuously by using implantable polarographic microprobes. Systemic oxygen transport variables and P(ti)o(2) were similar between groups at baseline. The oxygen delivery index increased significantly with transfusion of allogeneic RBCs and 100% oxygen ventilation, whereas the oxygen consumption index remained unchanged. Oxygen 100% ventilation increased P(ti)o(2) significantly (from 24.0 +/- 5.1 mm Hg to 34.2 +/- 6.2 mm Hg), whereas no change was found after transfusion of allogeneic RBCs. Peak P(ti)o(2) values were 25.2 +/- 5.2 mm Hg and 26.3 +/- 6.5 mm Hg in the transfusion 1 and 2 groups, respectively. Transfusion of stored allogeneic RBCs was effective only in improving systemic oxygen delivery index, whereas 100% oxygen ventilation improved systemic oxygen transport and P(ti)o(2). This improved oxygenation status was most likely due to an increase in convective oxygen transport with a large driving gradient for diffusion of plasma-dissolved oxygen into the tissue.
引用
收藏
页码:2 / 11
页数:10
相关论文
共 33 条
[1]   Postoperative pain and subcutaneous oxygen tension [J].
Akça, O ;
Melischek, M ;
Scheck, T ;
Hellwagner, K ;
Arkiliç, CF ;
Kurz, A ;
Kapral, S ;
Heinz, T ;
Lackner, FX ;
Sessler, DI .
LANCET, 1999, 354 (9172) :41-42
[2]   Comparable postoperative pulmonary atelectasis in patients given 30% or 80% oxygen during and 2 hours after colon resection [J].
Akça, O ;
Podolsky, A ;
Eisenhuber, E ;
Panzer, O ;
Hetz, H ;
Lampl, K ;
Lackner, FX ;
Wittmann, K ;
Grabenwoeger, F ;
Kurz, A ;
Schultz, AM ;
Negishi, C ;
Sessler, DI .
ANESTHESIOLOGY, 1999, 91 (04) :991-998
[3]   SKELETAL-MUSCLE PARTIAL-PRESSURE OF OXYGEN IN PATIENTS WITH SEPSIS [J].
BOEKSTEGERS, P ;
WEIDENHOFER, S ;
KAPSNER, T ;
WERDAN, K .
CRITICAL CARE MEDICINE, 1994, 22 (04) :640-650
[4]   Effect of anaemia and cardiovascular disease on surgical mortality and morbidity [J].
Carson, JL .
LANCET, 1996, 348 (9034) :1055-1060
[5]   The red cell storage lesion and its implication for transfusion [J].
ChinYee, I ;
Arya, N ;
dAlmeida, MS .
TRANSFUSION SCIENCE, 1997, 18 (03) :447-458
[6]   Clinical experience with 118 brain tissue oxygen partial pressure catheter probes [J].
Dings, J ;
Meixensberger, J ;
Jager, A ;
Roosen, K .
NEUROSURGERY, 1998, 43 (05) :1082-1094
[7]   Transfusing red blood cells stored in citrate phosphate dextrose adenine-1 for 28 days fails to improve tissue oxygenation in rats [J].
Fitzgerald, RD ;
Martin, CM ;
Dietz, GE ;
Doig, GS ;
Potter, RF ;
Sibbald, WJ .
CRITICAL CARE MEDICINE, 1997, 25 (05) :726-732
[8]   THE VARIABILITY OF TRANSFUSION PRACTICE IN CORONARY-ARTERY BYPASS-SURGERY [J].
GOODNOUGH, LT ;
JOHNSTON, MFM ;
TOY, PTCY .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1991, 265 (01) :86-90
[9]   Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection [J].
Greif, R ;
Akça, O ;
Horn, EP ;
Kurz, A ;
Sessler, DI .
NEW ENGLAND JOURNAL OF MEDICINE, 2000, 342 (03) :161-167
[10]  
Habler O, 1998, BRIT J ANAESTH, V81, P79