Effect of hypothermia on rectal mucosal perfusion in infants undergoing cardiopulmonary bypass
| Autor: | R Franks, Peter D. Booker, D P Prosser |
|---|---|
| Rok vydání: | 1996 |
| Předmět: |
Heart Defects
Congenital Mean arterial pressure Hemodynamics Blood Pressure law.invention Hypothermia Induced Degree Celsius law Monitoring Intraoperative Laser-Doppler Flowmetry Cardiopulmonary bypass Humans Medicine Intestinal Mucosa Cardiopulmonary Bypass business.industry Infant Newborn Rectum Infant Blood flow Laser Doppler velocimetry Hypothermia Anesthesiology and Pain Medicine Regional Blood Flow Anesthesia medicine.symptom business Perfusion |
| Zdroj: | British Journal of Anaesthesia. 77:591-596 |
| ISSN: | 0007-0912 |
| DOI: | 10.1093/bja/77.5.591 |
| Popis: | We have examined the effect of profound hypothermia on gut mucosal perfusion in 20 infants, aged 1.4-45 weeks, requiring cardiopulmonary bypass (CPB). After induction of anaesthesia, a laser Doppler probe was inserted 8 cm into the patient's rectum to allow monitoring of rectal mucosal perfusion ("flux") throughout operation. Steady-state observation periods (5 min with no change in temperature or mean arterial pressure (MAP) were achieved after 10 min on CPB at 35 degrees C, after CPB-induced cooling to 15-25 degrees C, immediately before rewarming and after rewarming to 35 degrees C. Throughout these periods flow rate was 100 ml kg-1 min-1, packed cell volume was kept constant and Paco2 maintained at 5.3 +/- 0.5 kPa. No vasoactive drugs were used. Initial warm and rewarm MAP values (46 mm Hg) were significantly lower (P = 0.008) than during the cold CPB periods (63 and 64 mm Hg). Mean flux in the first cold period (152) was significantly lower (P = 0.001) than that in the first warm CPB period (211). Post-rewarm flux (127) was significantly lower than all other CPB flux values (P = 0.004). We conclude that although hypothermia significantly reduced mucosal blood flow, rewarming produced even greater reductions in mucosal perfusion that may prove crucial in the development of mucosal hypoxia. |
| Databáze: | OpenAIRE |
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