Vedin Jenny, Jensen Ulf, Ericsson Anders, Samuelsson Sten, Vaage Jarle
Department of Cardiothoracic Surgery and Anesthesia, Karolinska University Hospital, 171 76 Stockholm, Sweden.
Interact Cardiovasc Thorac Surg. 2005 Oct;4(5):493-7. doi: 10.1510/icvts.2005.109363. Epub 2005 Jul 29.
To investigate the influence of cardiopulmonary bypass on pulmonary hemodynamics and gas exchange.
Low risk patients admitted for elective coronary artery bypass grafting were randomized to either on (n=25) or off pump (n=25) surgery. Central hemodynamics, gas exchange, and venous admixture were studied during and up to 20 h after surgery.
There was no difference in pulmonary vascular resistance index (P=0.16), right ventricular stroke work index (P>0.2), mean pulmonary artery pressure (P>0.2) or pulmonary capillary wedge pressure (P>0.2) between groups. Soon after surgery there was a tendency towards higher cardiac index (P=0.07) in the off pump group. Arterial oxygen tension (P>0.2), hematocrit (P>0.2), venous admixture (P>0.2), and arterial-venous oxygen content difference (P=0.12) did not differ between groups.
This prospective, randomized study showed no difference in pulmonary hemodynamics, pulmonary gas exchange, and venous admixture, in low risk patients undergoing off pump compared to on pump coronary artery bypass surgery.
研究体外循环对肺血流动力学和气体交换的影响。
将择期行冠状动脉旁路移植术的低风险患者随机分为体外循环组（n = 25）和非体外循环组（n = 25）。在手术期间及术后长达20小时内，研究中心血流动力学、气体交换和静脉血掺杂情况。
两组之间的肺血管阻力指数（P = 0.16）、右心室每搏功指数（P>0.2）、平均肺动脉压（P>0.2）或肺毛细血管楔压（P>0.2）无差异。术后不久，非体外循环组的心脏指数有升高趋势（P = 0.07）。两组之间的动脉血氧张力（P>0.2）、血细胞比容（P>0.2）、静脉血掺杂（P>0.2）和动静脉血氧含量差（P = 0.12）无差异。
这项前瞻性随机研究表明，与体外循环冠状动脉旁路移植术相比，非体外循环冠状动脉旁路移植术的低风险患者在肺血流动力学、肺气体交换和静脉血掺杂方面无差异。
