Document Detail

The effect of cardiopulmonary bypass on gastric and colonic mucosal perfusion: a tonometric assessment.
MedLine Citation:
PMID:  7919595     Owner:  NLM     Status:  MEDLINE    
In a study to assess the potential effect of nonpulsatile hypothermic cardiopulmonary bypass (CPB), intramucosal pH (pHi) of the gastric and colonic mucosae was determined by tonometry (n = 8). During the hypothermic phase of CPB, gastric and colonic pHi did not change significantly. Forty minutes after the start of rewarming, despite increases in the cardiac index and mean arterial blood pressure, gastric pHi fell from 7.53 +/- 0.02 to 7.31 +/- 0.03 (p = 0.017) and colonic pHi fell from 7.50 +/- 0.02 to 7.32 +/- 0.03 (p = 0.028). Forty minutes after the end of CPB both the colonic (p = 0.017) and gastric (p = 0.046) pHi remained depressed below pre-CPB values. The difference in the arterial (pHa) and the gastric mucosal pH changed from -0.097 before CPB to 0.016, 40 minutes after the end of CPB (p = 0.027). This alteration in the pHa-pHi underlines the importance of measuring intramucosal pH by tonometry, since the pHa and pHi may move in opposite directions during episodes of haemodynamic stress. Both the gastric and colonic pHi were found to have a linear correlation with the pHa, although changes in the gastric pHi (r = 0.41, p = 0.018) were more strongly correlated with the pHa than the colonic pHi (r = 0.23, p = 0.19) in the rewarming phase of CPB and the immediate post-CPB period when there was a tendency towards intramucosal acidosis. The development of intramucosal acidosis in the rewarming and immediate post-CPB phases following hypothermic nonpulsatile CPB may impair the gut barrier and predispose patients to the absorption of luminal toxins.
S K Ohri; C T Bowles; A Siddiqui; A Khaghani; B E Keogh; G Wright; M H Yacoub; K M Taylor
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Perfusion     Volume:  9     ISSN:  0267-6591     ISO Abbreviation:  Perfusion     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-11-10     Completed Date:  1994-11-10     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8700166     Medline TA:  Perfusion     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  101-8     Citation Subset:  IM    
Department of Surgery, Hammersmith Hospital, Royal Postgraduate Medical School, London, UK.
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MeSH Terms
Blood Pressure
Cardiopulmonary Bypass*
Digestive System / blood supply
Digestive System Physiological Phenomena
Gastric Mucosa / blood supply*,  physiology
Intestinal Mucosa / blood supply*,  physiology
Regional Blood Flow

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