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Comparison of pH-Stat Versus Alpha-Stat During Hypothermic Cardiopulmonary Bypass in the Prevention and Control of Acidosis in Cardiac Surgery

Piccioni, Marilde A. ; Leirner, Adolfo A. ; Auler Jr, José O.

Artificial organs, 2004-04, Vol.28 (4), p.347-352 [Periódico revisado por pares]

Oxford, UK and Malden, USA: Blackwell Science Inc

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  • Título:
    Comparison of pH-Stat Versus Alpha-Stat During Hypothermic Cardiopulmonary Bypass in the Prevention and Control of Acidosis in Cardiac Surgery
  • Autor: Piccioni, Marilde A. ; Leirner, Adolfo A. ; Auler Jr, José O.
  • Assuntos: Acid-Base Equilibrium - physiology ; Acidosis, Respiratory - prevention & control ; Aged ; Alpha-stat ; Blood acid-base state ; Body Temperature - physiology ; Carbon Dioxide - administration & dosage ; Carbon Dioxide - blood ; Coronary Artery Bypass ; Female ; Hemodynamics - physiology ; Humans ; Hydrogen-Ion Concentration ; Hypothermia, Induced ; Hypothermic cardiopulmonary bypass ; Lactic Acid - blood ; Male ; Middle Aged ; pH-stat ; Rewarming
  • É parte de: Artificial organs, 2004-04, Vol.28 (4), p.347-352
  • Notas: ArticleID:AOR47353
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  • Descrição: :  Objectives: To compare the effects of blood‐gas management using either alpha‐stat (temperature‐uncorrected blood‐gas management) or pH‐stat (temperature‐corrected blood‐gas management) strategies, 30 patients undergoing coronary artery bypass surgery allocated randomly to either one of the approaches were studied. Acid–base balance, tissue oxygenation, and biochemical parameters were measured at distinct times: before bypass, after 15 min of hypothermia at 32°C, after 45 min of hypothermia at 32°C, after 15 min of rewarming at 37°C, and 45 min after the end of bypass in normothermic conditions. Results: The groups were similar with regard to physical characteristics, physiological parameters, and bypass time. In the pH‐stat group, CO2 administered with the aim of correcting pH for the patients hypothermic temperature caused a significant increase in temperature‐uncorrected PaCO2 and a decrease in arterial temperature‐uncorrected pH at 45 min. During the rewarming period and following bypass, the pH was lower and PaCO2 higher in the pH‐stat group (P < 0.001). Conclusion: It was found that during the rewarming period and following bypass, the resulting acidosis caused by the procedure was less in the alpha‐stat group. It was found that there were no difference between the two groups, with regard to tissue perfusion, as is seen by the tissue oxygenation parameters and  lactic  acid  concentration.
  • Editor: Oxford, UK and Malden, USA: Blackwell Science Inc
  • Idioma: Inglês
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