| Autor: |
Uozaki, Yasuhiro, Dihmis, Walid C., Yamauchi, Hidetoshi, Moczar, Madeleine, Miyama, Masatoshi, Pasteau, Fabien, Tixier, Denis, Bambang, Sektiari L., Loisance, Daniel Y. |
| Předmět: |
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| Zdroj: |
Artificial Organs; Jan2001, Vol. 25 Issue 1, p53-57, 5p |
| Abstrakt: |
Abstract: We previously demonstrated that tumor necrosis factor-α (TNF-α) increased following a reduction in systemic blood flow to 60% or less of the original cardiac output using a left ventricular assist device (LVAD). The aim of this study was to investigate the effect of reducing systemic blood flow on tissue oxygenation in the gastrointestinal tract (GIT) and the consequences of this on TNF-α release. LVADs were implanted in 9 pigs. The aorta was clamped, and thus the LVAD flow represented the entire systemic blood flow. Plasma TNF-α of the superior mesenteric vein was measured at baseline and during systemic blood flow changes. Simultaneously, pH, lactate, oxygen delivery index (Do2I), oxygen consumption index (Vo2I), and oxygen extraction (O2ER) in the GIT were measured. The pH decreased and the lactate level increased significantly (p < 0.05) at a systemic blood flow of 50% or less. The Vo2I was positively correlated with Do2I. The O2ER increased significantly (p < 0.05) with reductions in systemic blood flow to 30% or less. There was a significant (p < 0.01) correlation between TNF-α and O2ER at levels higher than 55%. These data demonstrate that the GIT oxygenation is inadequate with a reduction in systemic blood flow to 50% and that GIT oxygenation becomes critical at a reduction of 30%. During LVAD weaning, careful attention must be given to the GIT. The pH and lactate may be good markers of the adequacy of tissue oxygenation in the GIT. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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