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J Thorac Cardiovasc Surg 2002;123:394-395
© 2002 The American Association for Thoracic Surgery

Letters to the Editor

Alkalosis induced by alpha-stat management: Cause of neuronal injury after deep hypothermic circulatory arrest?

Carl Wong, MA, MB, BChir, FRCS, FRCSEd

Department of Cardiothoracic Surgery
Freeman Hospital
Newcastle upon Tyne, United Kingdom

To the Editor:

Miyamoto and Miyamoto's commentsGo 1 on the excellent article by Kurth and associatesGo 2 raise interesting issues that require further discussion.
Alpha-stat cardiopulmonary bypass is known to produce arterial alkalosis. The letter by Miyamoto and Miyamoto asserted that the cerebral injury found by Kurth and associates was caused by the detrimental effects of alkalosis on cerebral metabolism and well-being by the Bohr effect shifting the oxygen–hemoglobin dissociation curve to the left and exposing the brain to excitotoxic injury.
However, blood gas samples measured in standard blood gas machines are heated to 37°C. This alters the pH, PO2, and PCO2 . . . [Full Text of this Article]




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R. J. van Thiel, S. R. Koopman, J. J. M. Takkenberg, A. Derk Jan Ten Harkel, and A. J. J. C. Bogers
Metabolic alkalosis after pediatric cardiac surgery
Eur J Cardiothorac Surg, August 1, 2005; 28(2): 229 - 233.
[Abstract] [Full Text] [PDF]


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