Microvascular fluid exchange during CPB with deep hypothermia circulatory arrest or low flow
| Autor: | Venny Lise Kvalheim, Arve Mongstad, Øyvind Sverre Svendsen, Bjørg Elvevoll, Paul Husby, Lodve Stangeland |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Swine
Hypothermia 030204 cardiovascular system & hematology law.invention 03 medical and health sciences 0302 clinical medicine Cerebral microdialysis law Edema Cardiopulmonary bypass medicine Animals Radiology Nuclear Medicine and imaging Advanced and Specialized Nursing Cardiopulmonary Bypass business.industry General Medicine Extravasation Perfusion Fluid exchange 030228 respiratory system Cerebrovascular Circulation Anesthesia Circulatory system Female medicine.symptom Cardiology and Cardiovascular Medicine business Safety Research |
| Zdroj: | Perfusion. 32:661-669 |
| ISSN: | 1477-111X 0267-6591 |
| DOI: | 10.1177/0267659117715695 |
| Popis: | Objective: Use of deep hypothermic low-flow (DHLF) cardiopulmonary bypass (CPB) has been associated with higher fluid loading than the use of deep hypothermia circulatory arrest (DHCA). We evaluated whether these perfusion strategies influenced fluid extravasation rates and edema generation differently per-operatively. Materials and Methods: Twelve anesthetized pigs, randomly allocated to DHLF (n = 6) or DHCA (n = 6), underwent 2.5 hours CPB with cooling to 20°C for 30 minutes (min), followed by 30 min arrested circulation (DHCA) or 30 min low-flow circulation (DHLF) before 90 min rewarming to normothermia. Perfusion of tissues, fluid requirements, plasma volumes, colloid osmotic pressures and total tissue water contents were recorded and fluid extravasation rates calculated. During the experiments, cerebral microdialysis was performed in both groups. Results: Microvascular fluid homeostasis was similar in both groups, with no between-group differences, reflected by similar fluid extravasation rates, plasma colloid osmotic pressures and total tissue water contents. Although extravasation rates increased dramatically from 0.10 (0.11) ml/kg/min (mean with standard deviation in parentheses) and 0.16 (0.02) ml/kg/min to 1.28 (0.58) ml/kg/min and 1.06 (0.41) ml/kg/min (DHCA and DHLF, respectively) after the initiation of CPB, fluid filtrations during both cardiac arrest and low flow were modest and close to baseline values. Cerebral microdialysis indicated anaerobic metabolism and ischemic brain injury in the DHCA group. Conclusion: No differences in microvascular fluid exchange could be demonstrated as a direct effect of DHCA compared with DHLF. Thirty minutes of DHCA was associated with anaerobic cerebral metabolism and possible brain injury. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|