Kancir C B, Madsen T
Department of Anesthesia, Odense University Hospital, Denmark.
Scand J Thorac Cardiovasc Surg. 1992;26(2):151-5. doi: 10.3109/14017439209099070.
Variations of the phosphate concentration in plasma were studied in two groups of 12 patients undergoing cardiac surgery with hypothermic cardiopulmonary bypass (CPB). Management of the acid-base status differed between the groups, according to whether or not carbon dioxide was added to the anesthetic gas mixture during hypothermia ('pH-stat' vs. 'alpha-stat' mode) following correction vs. no correction of pCO2 and pH for body temperature. Phosphate variations throughout the study were mostly within normal limits. From the start to the end of CPB, the mean rise in phosphate levels was 70% in the pH-stat group and 37% in the alpha-stat group (p < 0.001). During 3 hours after CPB, the phosphate values continued to rise by a mean of 25% in the alpha-stat patients, but fell by a mean of 3% in the pH-stat patients (p < 0.001). Such different phosphate patterns during and immediately after CPB may reflect profound metabolic disturbances and may be related to the altering effects of CO2 addition and respiratory acidosis on intracellular metabolic activity and phosphate homeostasis.
在两组接受低温体外循环心脏手术的12名患者中，研究了血浆中磷酸盐浓度的变化。根据在低温期间（体温校正后与未校正pCO2和pH值）麻醉气体混合物中是否添加二氧化碳（“pH稳态”与“α稳态”模式），两组之间的酸碱状态管理有所不同。在整个研究过程中，磷酸盐的变化大多在正常范围内。从体外循环开始到结束，pH稳态组磷酸盐水平的平均升高为70%，α稳态组为37%（p<0.001）。在体外循环后3小时内，α稳态组患者的磷酸盐值继续平均升高25%，而pH稳态组患者的磷酸盐值平均下降3%（p<0.001）。体外循环期间及之后立即出现的这种不同的磷酸盐模式可能反映了严重的代谢紊乱，并且可能与添加CO2和呼吸性酸中毒对细胞内代谢活性和磷酸盐稳态的改变作用有关。
