Metabolic changes in surface-induced deep hypothermia combined with cardiopulmonary bypass for cardiac surgery.

Surface induced deep hypothermia combined with cardiopulmonary bypass (combined method) is excellent in open heart surgery of infants which combines each advantage of cardiopulmonary bypass and hypothermia. The present study was performed to investigate pathophysiological changes, especially metabolic changes, in combined method induced by two stressors such as cardiopulmonary bypass and hypothermia. In general, metabolic changes during hypothermia are temporarily enhanced immediately after the start of cardiopulmonary bypass. Lactacidemia and metabolic acidosis are rapidly improved after the start of perfusion rewarming, but abnormality of ceruloplasmin and cholesterol metabolism in the liver and hypopotassemia are not rapidly improved. Therefore, the treatment for these metabolic abnormalities seems to be necessary during and after the procedure.