Jugular Venous Oxygenation During Hypothermic Cardiopulmonary Bypass in Patients at Risk for Abnormal Cerebral Autoregulation: Influence of α-Stat Versus pH-Stat Blood Gas Management

被引：12

作者：

Hoover, Lance R. ^{[2
]}

Dinavahi, Radhika

Cheng, Wei-Ping

Cooper, John R., Jr.

Marino, Maria Rosa

Spata, Tyler C.

Daniels, Gaile L.

Vaughn, William K. ^{[3
]}

Nussmeier, Nancy A. ^{[1
]}

机构：

[1] SUNY Upstate Med Univ, Dept Anesthesiol, Syracuse, NY 13210 USA

[2] San Antonio Uniform Hlth Educ Consortium, Dept Cardiothorac Anesthesia, San Antonio, TX USA

[3] St Lukes Episcopal Hosp, Texas Heart Inst, Dept Biostat & Epidemiol, Houston, TX USA

来源：

ANESTHESIA AND ANALGESIA | 2009年 / 108卷 / 05期

关键词：

LUXURY PERFUSION; SATURATION; FLOW; TEMPERATURE; DESATURATION; DYSFUNCTION; METABOLISM; PACO2;

D O I：

10.1213/ane.0b013e318187c39d

中图分类号：

R614 [麻醉学];

学科分类号：

100217 ;

摘要：

In a prospective, randomized study of cardiac surgical patients at risk for impaired cerebral blood flow autoregulation, we compared alpha-stat and pH-stat blood gas management. The 40 patients enrolled had age >70 yr, diabetes, prior stroke, or uncontrolled hypertension. During hypothermia and early rewarming, jugular oxygen tensions were significantly lower in a-stat patients (n = 12) than pH-stat patients (n = 19; P < 0.05). During rewarming, jugular venous desaturation (i.e., SjvO(2) <50%) occurred in 6 of 12 a-stat patients, but no pH-stat patients (P = 0.0006). Patients at risk for poor cerebral autoregulation have higher oxygen tensions and saturations if pH-stat blood gas management is used during cardiopulmonary bypass.

引用

页码：1389 / 1393

页数：5

共 28 条

[1]

Benjamini Y, 2001, ANN STAT, V29, P1165

[2] CONTROLLING THE FALSE DISCOVERY RATE - A PRACTICAL AND POWERFUL APPROACH TO MULTIPLE TESTING [J].

BENJAMINI, Y ;

HOCHBERG, Y .

JOURNAL OF THE ROYAL STATISTICAL SOCIETY SERIES B-STATISTICAL METHODOLOGY, 1995, 57 (01) :289-300

[3] Effect of temperature and PaCO2 on cerebral embolization during cardiopulmonary bypass in swine [J].

Cook, DJ ;

Plöchl, W ;

Orszulak, TA .

ANNALS OF THORACIC SURGERY, 2000, 69 (02) :415-420

[4] Carbon dioxide management and the cerebral response to hemodilution during hypothermic cardiopulmonary bypass in dogs [J].

Cook, DJ ;

Boston, US ;

Orszulak, TA ;

Slater, JM .

ANNALS OF THORACIC SURGERY, 2001, 72 (04) :1331-1335

[5]

CROUGHWELL N, 1992, J THORAC CARDIOV SUR, V103, P549

[6]

CROUGHWELL N, 1990, CIRCULATION, V82, P407

[7] JUGULAR BULB SATURATION AND COGNITIVE DYSFUNCTION AFTER CARDIOPULMONARY BYPASS [J].

CROUGHWELL, ND ;

NEWMAN, MF ;

BLUMENTHAL, JA ;

WHITE, WD ;

LEWIS, JB ;

FRASCO, PE ;

SMITH, LR ;

THYRUM, EA ;

HURWITZ, BJ ;

LEONE, BJ ;

SCHELL, RM ;

REVES, JG .

ANNALS OF THORACIC SURGERY, 1994, 58 (06) :1702-1708

[8] WARMING DURING CARDIOPULMONARY BYPASS IS ASSOCIATED WITH JUGULAR BULB DESATURATION [J].

CROUGHWELL, ND ;

FRASCO, P ;

BLUMENTHAL, JA ;

LEONE, BJ ;

WHITE, WD ;

REVES, JG .

ANNALS OF THORACIC SURGERY, 1992, 53 (05) :827-832

[9] THEORETICAL-ANALYSIS OF CEREBRAL VENOUS-BLOOD HEMOGLOBIN OXYGEN-SATURATION AS AN INDEX OF CEREBRAL OXYGENATION DURING HYPOTHERMIC CARDIOPULMONARY BYPASS - A COUNTERPROPOSAL TO THE LUXURY PERFUSION HYPOTHESIS [J].

DEXTER, F ;

HINDMAN, BJ .

ANESTHESIOLOGY, 1995, 83 (02) :405-412

[10] The brain uses mostly dissolved oxygen during profoundly hypothermic cardiopulmonary bypass [J].

Dexter, F ;

Kern, FH ;

Hindman, BJ ;

Greeley, WJ .

ANNALS OF THORACIC SURGERY, 1997, 63 (06) :1725-1729

← 1 2 3 →