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The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 327-334, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
S Del Canale, A Vezzani, L Belli, E Coffrini, A Guariglia, N Ronda, P Vitali, C Beghi, F Fesani and A Borghetti
This study compares the effects of cardiopulmonary bypass with different
flows and pressures on intracellular energy metabolism, acid- base
equilibrium, and muscle water compartments in two groups of patients
undergoing coronary artery bypass grafting. Eighteen patients (16 men and
two women aged 54 +/- 7 years, New York Heart Association class I-II)
undergoing low flow (flow rate 1.5 L/min/m2 at 26 degrees C), low pressure
(mean arterial pressure 40 to 60 mm Hg) cardiopulmonary bypass, as well as
10 age-matched and sex-matched patients undergoing normal flow (flow rate
2.2 L/min/m2 at 26 degrees C), normal pressure (mean arterial pressure 60
to 80 mm Hg) bypass were studied. Intracellular acid-base equilibrium
(intracellular pH and intracellular bicarbonate), cell energetics
(adenosine triphosphate, diphosphate, and monophosphate, phosphocreatine,
and lactate), and muscle water compartments were evaluated in specimens of
the quadriceps femoris muscle obtained by needle biopsy before and at the
end of cardiopulmonary bypass. In both the low flow-low pressure and normal
flow-normal pressure groups, adenosine triphosphate levels were unchanged
at the end of bypass, whereas phosphocreatine concentration was decreased;
muscle total water and extracellular water increased without variations of
intracellular water; muscle and plasma lactate increased as intracellular
bicarbonate decreased; intracellular pH values remained unchanged. The
present study suggests the following: (1) Cardiopulmonary bypass is
associated with the overall preservation of intracellular compartment
metabolism in skeletal muscle (about 40% of body cell mass) of patients
undergoing coronary bypass grafting, even though low phosphocreatine values
and increased plasma and muscle lactate values found at the end of bypass
could be an expression of cell functional reserve exhaustion; (2) the
effects of cardiopulmonary bypass on cell metabolism are comparable,
regardless of the flows and pressures used.
ARTICLES
A comparative clinical study on the effects of cardiopulmonary bypass with different flows and pressures on skeletal muscle cell metabolism in patients undergoing coronary bypass grafting
Istituto di Clinica Medica e Nefrologia, Universita di Parma, Italy.
This article has been cited by other articles:
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  S. K Ohri and T. Velissaris Gastrointestinal Dysfunction Following Cardiac Surgery Perfusion, July 1, 2006; 21(4): 215 - 223. [PDF]
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R Zamparelli, S De Paulis, L Martinelli, M Rossi, A Scapigliati, M Sciarra, F Meo, and R Schiavello Pulsatile normothermic cardiopulmonary bypass and plasma catecholamine levels Perfusion, May 1, 2000; 15(3): 217 - 223. [Abstract] [PDF]
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 S. K. Ohri, J. Becket, J. Brannan, B. E. Keogh, and K. M. Taylor Effects of cardiopulmonary bypass on gut blood flow, oxygen utilization, and intramucosal pH Ann. Thorac. Surg., May 1, 1994; 57(5): 1193 - 1199. [Abstract] [PDF]
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E. G. Ford, C. E. Baisden, M. L. Matteson, and A. L. Picone Sepsis after coronary bypass grafting: Evidence for loss of the gut mucosal barrier Ann. Thorac. Surg., September 1, 1991; 52(3): 514 - 517. [Abstract] [PDF]
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