先天性心脏病的常氧和高氧体外循环

Mokhtari Amir, Lewis Martin

Bristol Heart Institute, University of Bristol, Bristol BS2 8HW, UK ; Department of Cardiology, School of Clinical Sciences, Faculty of Medicine and Dentistry, University of Bristol, Bristol BS10 5NB, UK ; Department of Cardiac Surgery, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds LS1 3EX, UK.

Bristol Heart Institute, University of Bristol, Bristol BS2 8HW, UK ; Bristol Royal Infirmary, University Hospitals Bristol NHS Foundation Trust, Bristol BS2 8HW, UK ; School of Clinical Sciences, University of Bristol, 69 St Michael's Hill, Bristol BS2 8DZ, UK.

Biomed Res Int. 2014;2014:678268. doi: 10.1155/2014/678268. Epub 2014 Sep 18.

Cyanotic congenital heart disease comprises a diverse spectrum of anatomical pathologies. Common to all, however, is chronic hypoxia before these lesions are operated upon when cardiopulmonary bypass is initiated. A range of functional and structural adaptations take place in the chronically hypoxic heart, which, whilst protective in the hypoxic state, are deleterious when the availability of oxygen to the myocardium is suddenly improved. Conventional cardiopulmonary bypass delivers hyperoxic perfusion to the myocardium and is associated with cardiac injury and systemic stress, whilst a normoxic perfusate protects against these insults.

青紫型先天性心脏病包含多种解剖学病变。然而，在这些病变接受手术、启动体外循环之前，所有患者都存在慢性缺氧的情况。慢性缺氧的心脏会发生一系列功能和结构上的适应性变化，这些变化在缺氧状态下具有保护作用，但当心肌的氧供应突然改善时则会产生有害影响。传统的体外循环会向心肌输送高氧灌注，这与心脏损伤和全身应激相关，而常氧灌注液则可防止这些损伤。