Document Detail


Myocardial oxygen balance during hemodilution in patients undergoing coronary artery bypass grafting.
MedLine Citation:
PMID:  6609819     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The myocardial (arterial-coronary sinus) balance of oxygen and lactate was studied before a cardiopulmonary bypass and during the first 5 min of a normothermic bypass in two patient groups undergoing coronary revascularization for multiple coronary artery disease. The hemodilution (HD) group was hemodiluted before the bypass with dextran 70 (15 ml/kg; resulting mean hematocrit 32%) and further at the beginning of the bypass due to nonhemic priming of the oxygenator (mean hematocrit 15%). The control (C) group was not diluted before the bypass, and four units of red blood cells were included in the oxygenator priming (mean hematocrit 27% after the beginning of the bypass). The preoperative dilution produced a decline in the coronary sinus blood oxygen tension and oxygen saturation, but no change in the arterial-coronary sinus lactate balance. After the first 5 min of the bypass, the heart produced lactate in both the HD group and the C group, but the lactate production was more pronounced in the HD group. At the same time, the coronary sinus blood oxygen saturation was lower in the HD group than in the C group. Hypotension frequently accompanied the beginning of the bypass in both groups. It is concluded that the hemodilution to a hematocrit level of 32% in patients undergoing coronary revascularization for multiple stable coronary artery disease produces compensatory changes in myocardial oxygen extraction, but no changes of a generalized ischemia can be demonstrated. The hemodilution to a hematocrit level of 15% produces myocardial ischemia in patients with a normothermic unloaded heart, adding to the effect of hypotension at the beginning of the bypass.
Authors:
J Jalonen; O Meretoja; V Laaksonen; J Niinikoski; M V Inberg
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European surgical research. Europäische chirurgische Forschung. Recherches chirurgicales européennes     Volume:  16     ISSN:  0014-312X     ISO Abbreviation:  Eur Surg Res     Publication Date:  1984  
Date Detail:
Created Date:  1984-07-02     Completed Date:  1984-07-02     Revised Date:  2006-11-30    
Medline Journal Info:
Nlm Unique ID:  0174752     Medline TA:  Eur Surg Res     Country:  SWITZERLAND    
Other Details:
Languages:  eng     Pagination:  141-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Coronary Artery Bypass*
Coronary Disease / metabolism
Hematocrit
Hemodilution*
Humans
Middle Aged
Myocardial Revascularization
Myocardium / metabolism*
Oxygen Consumption*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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