Ota Y, Tsunemoto M, Shimada M, Kazuma H, Sugimoto T, Otsuka K
Department of Cardiovascular Surgery, National Children's Hospital.
Kyobu Geka. 1991 Mar;44(3):219-28.
Myocardial acidosis as reflected in pH measured by a glass (G) electrode during ischemic arrest may adversely affect postoperative cardiac function. However, (G) is slow in response and fragile. We report the development of an antimony electrode (Sb) and a pH meter based on our investigation and the results of their clinical application. As a biological material, CPD blood was chosen and subjected to a series of experiments determine its pH by (Sb) and (G). There was a small (within 0.1), but statistically significant difference in pH between (Sb) and (G). To simulate myocardial cooling during operation, CPD blood was cooled and its pH measured by (Sb) and (G). (Sb) showed significantly different behaviour from (G), i,e, the pH tended to fall with the falling temperature, whereas with (G) it tended to rise as had been previously known. The thermodynamic property of (Sb) was checked in appropriate buffer solutions by varying their temperatures. There was an almost linear correlation between EMF by (Sb) and the temperature of the buffer solutions (1 mV/1 degree C, or 0.017 pH/1 degree C). Accordingly, a pH meter incorporating an electronic circuit compensating for the temperature-depending EMF and a (Sb) with a built-in-thermocouple were constructed. Utilizing the new apparatus, CPD blood was again tested and it was proved that the new electrode and the pH meter worked in similar manner to (G). The new apparatus was applied to a series of measurement of intramyocardial pH during open-heart surgery and the results compared with that previously obtained by (G). There were no significant differences either between control pH or rate of its fall in the initial 10 minutes. following aortic cross-clamping and the administration of the cardioplegic solution. It is concluded that although (Sb) is not as accurate as (G), it is a reasonable alternative for the determination of the intramyocardial pH during open-heart surgery.
在缺血性心脏停搏期间,通过玻璃(G)电极测量的pH值所反映的心肌酸中毒可能会对术后心脏功能产生不利影响。然而,(G)电极响应缓慢且易碎。我们报告了基于我们的研究及其临床应用结果开发的锑电极(Sb)和pH计。作为生物材料,选择了CPD血,并通过(Sb)和(G)电极对其进行了一系列实验以测定其pH值。(Sb)和(G)测量的pH值存在微小差异(在0.1以内),但具有统计学意义。为了模拟手术期间的心肌降温,对CPD血进行冷却,并通过(Sb)和(G)电极测量其pH值。(Sb)显示出与(G)明显不同的行为,即pH值倾向于随着温度下降而下降,而对于(G)电极,正如之前所知,pH值倾向于随着温度下降而上升。通过在适当的缓冲溶液中改变温度来检查(Sb)电极的热力学性质。(Sb)电极产生的电动势与缓冲溶液的温度之间几乎呈线性关系(1 mV/1℃,或0.017 pH/1℃)。因此,构建了一种包含用于补偿温度依赖性电动势的电子电路的pH计和内置热电偶的(Sb)电极。使用新设备再次对CPD血进行测试,结果证明新电极和pH计的工作方式与(G)电极相似。新设备应用于心脏直视手术期间心肌内pH值的一系列测量,并将结果与之前通过(G)电极获得的结果进行比较。在主动脉交叉钳夹和给予心脏停搏液后的初始10分钟内,对照pH值或其下降速率之间均无显著差异。结论是,虽然(Sb)电极不如(G)电极精确,但它是心脏直视手术期间测定心肌内pH值的合理替代方法。