Measurement of intraperitoneal metabolites during hypothermic cardiopulmonary bypass using microdialysis

Adluri, Rajeshwara Krishna Prasad; Singh, Avadhesh Pratap; Skoyles, Julian; Baker, Mya; Mitchell, Ian M.

doi:10.3109/14017431.2011.572995

Cited by 8 publications

(10 citation statements)

References 27 publications

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“…Patients undergoing cardiac surgery under extracorporeal circulation have been shown to develop an increased l/p ratio and former studies support that patients with atrial fibrillation might have short episodes of l/p ratio elevation. 27,42 This finding emphasises that the ip l/p ratio is unspecific and might reflect any organ hypoperfusion or inflammatory process. 43 This series has a higher percentage of severe IAH than reported in the literature.…”

Section: Discussionmentioning

confidence: 91%

Intra-peritoneal Microdialysis and Intra-abdominal Pressure after Endovascular Repair of Ruptured Aortic Aneurysms

Hörer

Skoog

Norgren

et al. 2013

European Journal of Vascular and Endovascular Surgery

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Section: Discussionmentioning

confidence: 91%

Intra-peritoneal Microdialysis and Intra-abdominal Pressure after Endovascular Repair of Ruptured Aortic Aneurysms

Hörer

Skoog

Norgren

et al. 2013

European Journal of Vascular and Endovascular Surgery

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“…Microcirculation fails in nonpulsatile flow and during hypothermia, however redistribution occurs, especially during the hypothermic period of CPB, and although tissue hypoxia exists blood lactate levels may stay within normal range similar to other tissue perfusion parameters. [3][4][5][6][7][8] However, when the regional perfusion improves, there is an increase in blood lactate levels (wash-out). In order to diagnose poor tissue perfusion in time, all of the indirect tissue perfusion parameters should be closely monitored and evaluated during CPB since they work in conjunction with each other.…”

Section: Discussionmentioning

confidence: 99%

“…[3,4] However, it is known that changes in the levels of blood lactate are affected by several factors during CPB. [5][6][7][8] Partial pressure of carbon dioxide (pCO2) in venous blood and the partial pressure of veno-arterial carbon dioxide (Dv-apCO2) gradients increase due to cessation of circulation, traumatic shock, or inadequate circulation resulting from severe sepsis or a decrease in systemic or pulmonary circulation. [9] During CPB, similar states in systemic and pulmonary circulation have been encountered, and the term "sepsis-like syndrome" has been used for CPB.…”

mentioning

confidence: 99%

Is the venoarterial carbondioxide gradient and lactate predictor of inadequate tissue perfusion during cardiopulmonary bypass?

Toraman¹,

Özgen²,

Şenay³

et al. 2012

Turk Gogus Kalp Dama

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Bu çalışmada kardiopulmoner baypas (KPB) sırasında venoarteriyel karbondioksit farkı (Dv-a PCO2) ve laktat arasındaki muhtemel ilişkisi araştırıldı. Ça lış mapla nı:Hastanemiz etik kurulu onayı ve hasta onamları alınan elektif izole koroner arter baypas greft (KABG) cerrahisi yapılacak 60 ardışık hasta (35 erkek, 53 kadın; ort. yaş 64 yıl; dağılım 38-78 yıl) çalışmaya alındı. Tüm hastalar aynı anestezi ve cerrahi ekip tarafından izlendi. Kardiopulmoner baypas süresince doku perfüzyonun yeterliliği venoarteriyel parsiyel karbondioksit farkı, laktat düzeyi, arteriyel ve venöz kan gazı ölçümü, idrar çıkış hızı ve hemodinamik parametrelerin analizi ile değerlendirildi. Ölçümler kardiopulmoner baypas öncesi (T1), KPB başlangıcında 36 ºC'de (T2), hipotermide 32 ºC'de (T3) ve yeniden ısınmanın sonunda 37 ºC'de (T4) olmak üzere dört periyotta yapıldı. Doku perfüzyon parametreleri arasındaki ilişki, Pearson korelasyon analizi ile değerlendirildi. Bul gu lar: Kardiopulmoner baypasın T2 ile T4 periyotları arasında doku perfüzyon parametrelerinden Dv-aPCO2 ile arteriyel laktat düzeyi (r= 0.55, p= 0.042) ve Dv-aPCO2 ile venöz laktat (r=0.54, p=0.046) arasında anlamlı ilişki vardı. T3-T4 periyotları arasında da Dv-aPCO2 ile arteriyel base excess (BE) (r=-064, p= 0.013,), Dv-aPCO2 ile arteriyel HCO3 (r=-0.54, p=0.048) arasında anlamlı ilişki vardı. So nuç: Çalışma bulgularımız, hipotermi döneminde, karbondioksit çözünürlüğündeki değişikliğe bağlı olarak, KBP sırasında venoarteriyel karbondioksit farkındaki (Dv-aPCO2) artışın yetersiz kan akımı ile ters orantılı olmadığını ve hipotermi periyodu dışındaki dönemlerde, Dv-aPCO2 ile doku perfüzyon parametreleri arasında anlamlı bir ilişkinin olduğunu göstermiştir. Anah tar söz cük ler: Kardiyopulmoner baypas; doku perfüzyonu; venoarteriyel karbondioksit farkı. Background:In this study, we aimed to investigate the possible relationship between the venoarterial gradient of carbon dioxide (Dv-a PCO2) and lactate during cardiopulmonary bypass (CPB). Methods: Sixty consecutive patients (35 males, 53 females; mean age 64 years; range 38 to 78 years) who were scheduled for elective isolated coronary artery bypass graft (CABG) surgery were included in the study after obtaining their informed consent and the approval of the ethics committee of the hospital. All patients were followed up by the same surgical and anesthesia team. The adequacy of tissue perfusion during CPB was evaluated by the venoarterial partial carbon dioxide gradient, lactate level, measurement of arterial and venous blood gas, urinary flow rate, and hemodynamic parameters. The measurements were performed in four periods: before CPB (T1), at the beginning of CPB (T2) at 36 ºC and 32 ºC of hypothermia (T3) and at the end of rewarming (T4) at 37 ºC. The relationship between tissue perfusion parameters was assessed by Pearson's correlation analysis. Results:There was a significant correlation between Dv-aPCO2 and the venous lactate level (r= 0.54, p= 0.046) as well as between Dv-aPCO2 and the arterial lactate level (r= 0.55, ...

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“…Lactate is the main indicator of tissue perfusion [11]. Microcirculation is impaired during non pulsetile hypothermic CPB leading to tissue hypoxia which may be compen-sated by redistribution of blood without any change in serum lactate that will be elevated when the regional perfusion is returned to normal level (wash out) [12,13].…”

Section: Heart Rate (Beat/min)mentioning

confidence: 99%

Effects of phentolamine infusion during normoxic cardiopulmonary bypass on the outcome of cardiac surgery in children with cyanotic heart disease

Baser

Sharkawy

2017

Egyptian Journal of Anaesthesia

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Measurement of intraperitoneal metabolites during hypothermic cardiopulmonary bypass using microdialysis

Abstract: This prospective study confirms incidence of intraperitoneal anaerobic metabolism of glucose during CPB and impaired utilisation of glucose in the postoperative period. Microdialysis provides a novel and minimally-invasive method to measure real time intraperitoneal events.

Cited by 8 publications

References 27 publications

Intra-peritoneal Microdialysis and Intra-abdominal Pressure after Endovascular Repair of Ruptured Aortic Aneurysms

Intra-peritoneal Microdialysis and Intra-abdominal Pressure after Endovascular Repair of Ruptured Aortic Aneurysms

Is the venoarterial carbondioxide gradient and lactate predictor of inadequate tissue perfusion during cardiopulmonary bypass?

Effects of phentolamine infusion during normoxic cardiopulmonary bypass on the outcome of cardiac surgery in children with cyanotic heart disease

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