Tirilomis Theodor, Liakopoulos Oliver J, Coskun K Oguz, Bensch Marc, Popov Aron-Frederik, Schmitto Jan D, Schoendube Friedrich A
Department for Thoracic, Cardiac, and Vascular Surgery, Goettingen University, Goettingen, Germany.
J Cardiothorac Surg. 2010 Nov 2;5:98. doi: 10.1186/1749-8090-5-98.
Hemodynamic function may be depressed in the early postoperative stages after cardiac surgery. The aim of this study was the analysis of the myocardial contractility in neonates after cardiopulmonary bypass (CPB) and mild hypothermia.
Three indices of left ventricular myocardial contractile function (dP/dt, (dP/dt)/P, and wall thickening) were studied up to 6 hours after CPB in neonatal piglets (CPB group; n = 4). The contractility data were analysed and then compared to the data of newborn piglets who also underwent median thoracotomy and instrumentation for the same time intervals but without CPB (non-CPB group; n = 3).
Left ventricular dP/dtmax and (dP/dtmax)/P remained stable in CPB group, while dP/dtmax decreased in non-CPB group 5 hours postoperatively (1761 ± 205 mmHg/s at baseline vs. 1170 ± 205 mmHg/s after 5 h; p < 0.05). However, with regard to dP/dtmax and (dP/dtmax)/P there were no statistically significant differences between the two groups. Comparably, although myocardial thickening decreased in the non-CPB group the differences between the two groups were not statistically significant.
The myocardial contractile function in survived neonatal piglets remained stable 6 hours after cardiopulmonary bypass and mild hypothermia probably due to regional hypercontractility.
心脏手术后早期血流动力学功能可能会受到抑制。本研究的目的是分析新生儿体外循环(CPB)和轻度低温后的心肌收缩力。
在新生仔猪体外循环后6小时内研究左心室心肌收缩功能的三个指标(dP/dt、(dP/dt)/P和心肌增厚)(CPB组;n = 4)。分析收缩力数据,然后与同期也接受正中开胸和仪器植入但未进行体外循环的新生仔猪的数据进行比较(非CPB组;n = 3)。
CPB组左心室dP/dtmax和(dP/dtmax)/P保持稳定,而非CPB组术后5小时dP/dtmax下降(基线时为1761±205 mmHg/s,5小时后为1170±205 mmHg/s;p < 0.05)。然而,关于dP/dtmax和(dP/dtmax)/P,两组之间无统计学显著差异。同样,尽管非CPB组心肌增厚减少,但两组之间的差异无统计学意义。
存活的新生仔猪在体外循环和轻度低温后6小时心肌收缩功能保持稳定,可能是由于局部收缩力增强。