| Ischemic threshold during cold blood cardioplegic arrest: monitoring with tissue pH and pO2. | |
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MedLine Citation:
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PMID: 9833718 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Several studies have suggested that measuring interstitial pH and pO2, may be useful to monitor ischemia throughout cardioplegic arrest during cardiac surgery. METHODS: To evaluate the levels of myocardial tissue pH and pO2 that correlate with significant ischemia, 7 dogs underwent cold blood cardioplegic arrest and subsequent incremental episodes of 5, 10, 20 and 40 min of ischemia interrupted by cardioplegic infusion over 10-min periods. RESULTS: Myocardial tissue pH and pO2 were monitored with probes implanted in the anterior and lateral walls of the left ventricle. The release of CK, troponine T and lactate was measured before and after each episode of ischemic arrest. Tissue pH decreased from 7.08+/-0.15 to 7.03+/-0.15 (p>0.05), 7.21+/-0.15 to 7.07+/-0.11 (p>0.05), 7.17+/-0.15 to 6.82+/-0.14 (p<0.05) and 7.0+/-0.18 to 6.63+/-0.08 (p<0.05) after 5, 10, 20 and 40 min of ischemic arrest. Tissue pO2 decreased from 74+/-10 to 38+/-11 mmHg (p<0.05), 83+/-16 to 18+/-4 mmHg (p<0.05), 9+/-22 to 14+/-5 mmHg (p<0.05) and 64+/-24 to 16+/-10 mmHg (p<0.05) after 5, 10, 20 and 40 min of ischemic arrest. CK, troponine T and lactate serum levels increased significantly only following 40 min of ischemic arrest. Myocardial temperature decreased to an average minimum of 14+/-1 degrees C during cardioplegic infusion. CONCLUSIONS: A myocardial tissue pH lower than 7.04 (90% CI, upper limit of 6.82+/-0.14) and a tissue pO2 lower than 22 mmHg (90% CI, upper limit of 14+/-5 mmHg) correlate with anaerobic metabolism and myocardial ischemia during cold cardioplegic arrest. |
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Authors:
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M Carrier; S Trudelle; P Thai; L Pelletier |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: The Journal of cardiovascular surgery Volume: 39 ISSN: 0021-9509 ISO Abbreviation: J Cardiovasc Surg (Torino) Publication Date: 1998 Oct |
Date Detail:
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Created Date: 1998-12-11 Completed Date: 1998-12-11 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0066127 Medline TA: J Cardiovasc Surg (Torino) Country: ITALY |
Other Details:
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Languages: eng Pagination: 593-7 Citation Subset: IM |
Affiliation:
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Cardiovascular Division, Montreal Heart Institute, QC, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anaerobic Threshold*
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physiology Animals Biological Markers Creatine Kinase / metabolism Dogs Heart Arrest, Induced* Hydrogen-Ion Concentration Hypothermia, Induced* Lactic Acid / metabolism Monitoring, Intraoperative Myocardial Ischemia / metabolism* Myocardium / metabolism* Troponin T / metabolism |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Troponin T; 50-21-5/Lactic Acid; EC 2.7.3.2/Creatine Kinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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