Kiziltan H T, Baltali M, Koca D, Oner S, Sener M, Tasdelen A
Department of Cardiothoracic Surgery, Baskent University, Adana Medical Center, Adana 01250, Turkey.
Cardiovasc Surg. 2003 Jun;11(3):213-7. doi: 10.1016/s0967-2109(03)00005-x.
Deep hypothermic circulatory arrest may impair cerebral cellular functions, and physiological parameters following circulatory arrest may deviate from the normal. The intention of this study was to monitor jugular venous oxygen saturation during cardiopulmonary bypass before and after deep hypothermic circulatory arrest. Jugular venous oxygen saturation were obtained on 18 patients by using a retrograde jugular vein catheter during replacement of the ascending aorta. Indications for operations were ascending aortic dilatation (n=15) and acute aortic dissection (n=3). Hypothermic cardiopulmonary bypass (233+/-60 min), cardioplegic arrest (105+/-37 min) and circulatory arrest (22+/-7 min) were utilized during the operations. Jugular venous oxygen saturation increased during hypothermia and decreased during rewarming. Compared with cooling, jugular venous oxygen saturation during the initial part of rewarming were significantly lower (87+/-5% vs. 97+/-1%, 89+/-4% vs. 95+/-2%, 81+/-4% vs. 87+/-5% at 16, 20 and 24 degrees C respectively, p<0.05). One patient required re-exploration because of bleeding. All patients were found neurologically normal before being discharged from the hospital (mean 14+/-7 days). In conclusion, jugular venous oxygen saturation is inversely related to the body temperature in patients undergoing hypothermic cardiopulmonary bypass. Significantly decreased jugular venous oxygen saturation during the initial part of rewarming may signify an increased cerebral extraction of oxygen.
深度低温循环停止可能会损害脑细胞功能，循环停止后的生理参数可能会偏离正常范围。本研究的目的是监测深度低温循环停止前后体外循环期间的颈静脉血氧饱和度。在18例患者升主动脉置换术中，通过逆行颈静脉导管获取颈静脉血氧饱和度。手术指征为升主动脉扩张（n = 15）和急性主动脉夹层（n = 3）。手术期间采用低温体外循环（233±60分钟）、心脏停搏（105±37分钟）和循环停止（22±7分钟）。低温期间颈静脉血氧饱和度升高，复温期间降低。与降温相比，复温初期的颈静脉血氧饱和度显著降低（分别在16℃、20℃和24℃时为87±5%对97±1%、89±4%对95±2%、81±4%对87±5%，p<0.05）。1例患者因出血需要再次开胸探查。所有患者出院前神经功能均正常（平均14±7天）。总之，低温体外循环患者的颈静脉血氧饱和度与体温呈负相关。复温初期颈静脉血氧饱和度显著降低可能表明脑氧摄取增加。
