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[体外循环的研究。特别是关于快速灌注降温期间酸碱平衡、血清电解质和谷草转氨酶的变化(作者译)]

[Studies on the extracorporeal circulation. Especially on changes in acid-base balance, serum electrolytes and S-GOT during rapid perfusion cooling (author's transl)].

作者信息

Goto Y

出版信息

Hokkaido Igaku Zasshi. 1975 Mar;50(2):197-215.

PMID:1104458
Abstract

Experiments were made using 47 mongrel dogs under normo-and hypothermic perfusion employing the DeWall-Lillehei and Kay-Cross oxygenator. The purpose of this study is to find the ideal method of extracorporeal circulation as an adjunct of cardiac surgery. In this report, the changes of acid-base balance, serum electrolytes and S-GOT during perfusion were investigated. The results obtained were as follows. 1) In spite of the hypothermia, the changes of pH and buffer base in 10 degrees C hypothermic circulatory arrest indicated the gradual progress of the tissue metabolism. After the circulation restarted uncompensated metabolic acidosis without decrease of H2CO3 ensued. The circulatory arrest for 30 minutes in 10 degrees C hypothermia was thought to be hazardous to the preservation of life. 2) In case of ventricular fibrillation, hyperkalemia in the systemic venous blood was often found. It was also observed in the coronary venous blood. In accordance with the fact of hyperkalamia during anoxia, it is presumed that the cardiac anoxia is the important factor for the development of ventricular fibrillation. 3) The value of S-GOT in the arterial blood was not influenced by perfusion time, cardiac arrest and temperature, so far as the perfusion was performed smoothly. S-GOT was elevated when cardiotomy was carried out.

摘要

使用德瓦尔-利勒黑(DeWall-Lillehei)和凯-克罗斯(Kay-Cross)人工心肺机,在常温和低温灌注条件下,对47只杂种狗进行了实验。本研究的目的是寻找作为心脏手术辅助手段的理想体外循环方法。在本报告中,研究了灌注期间酸碱平衡、血清电解质和谷草转氨酶(S-GOT)的变化。获得的结果如下。1)尽管体温降低,但在10℃低温循环停止时,pH值和缓冲碱的变化表明组织代谢在逐渐进展。循环重新开始后,出现了未代偿的代谢性酸中毒,而碳酸(H2CO3)没有降低。在10℃低温下循环停止30分钟被认为对生命保存有危险。2)在心室颤动的情况下,经常发现体静脉血中有高钾血症。在冠状静脉血中也观察到了这种情况。根据缺氧时高钾血症的事实,推测心脏缺氧是心室颤动发生的重要因素。3)只要灌注顺利进行,动脉血中谷草转氨酶的值不受灌注时间、心脏停搏和温度的影响。进行心脏切开术时,谷草转氨酶会升高。

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