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体外循环心脏手术后即刻右心房至肺动脉的氧饱和度及乳酸浓度梯度

Oxygen saturation and lactate concentration gradient from the right atrium to the pulmonary artery in the immediate postoperative following cardiac surgery with extracorporeal circulation.

作者信息

Pendino Juan Carlos, Hess Leonardo, Beltrame Sergio, Castillo Gonzalo Aldamiz-Echevarría, Trujillo John

机构信息

Unidad de Terapia Intensiva, Hospital Provincial del Centenario - Rosário, Argentina.

Facultad de Ciências Médicas, Universidad Nacional de Rosario - Rosário, Argentina.

出版信息

Rev Bras Ter Intensiva. 2017 Jul-Sep;29(3):287-292. doi: 10.5935/0103-507X.20170042. Epub 2017 Sep 4.

Abstract

OBJECTIVE

This prospective study aimed to characterize the changes in blood lactate concentration and blood oxygen saturation in patients during the immediate postoperative period of cardiac surgery with extracorporeal circulation.

METHODS

Blood samples were collected from 35 patients in a rapid and random order from the arterial line and from the proximal and distal port of a pulmonary artery catheter.

RESULTS

The results showed no statistically significant differences between the blood oxygen saturation in the right atrium (72% ± 0.11%) and the blood oxygen saturation in the pulmonary artery (71% ± 0.08%). The blood lactate concentration in the right atrium was 1.7mmol/L ± 0.5mmol/L, and the blood lactate concentration in the pulmonary artery was 1.6mmol/L ± 0.5mmol/L (p < 0.0005).

CONCLUSION

The difference between the blood lactate concentration in the right atrium and the blood lactate concentration in the pulmonary artery might be a consequence of the low blood lactate concentration in the blood from the coronary sinus, as it constitutes an important substrate for the myocardium during this period. The lack of differences between the blood oxygen saturation in the right atrium and the percentage of blood oxygen saturation in the pulmonary artery suggests a lower oxygen extraction by the myocardium given a lower oxygen consumption.

摘要

目的

这项前瞻性研究旨在描述体外循环心脏手术后患者术后即刻血乳酸浓度和血氧饱和度的变化。

方法

从35例患者的动脉管路以及肺动脉导管的近端和远端端口快速随机采集血样。

结果

结果显示右心房血氧饱和度(72%±0.11%)与肺动脉血氧饱和度(71%±0.08%)之间无统计学显著差异。右心房血乳酸浓度为1.7mmol/L±0.5mmol/L,肺动脉血乳酸浓度为1.6mmol/L±0.5mmol/L(p<0.0005)。

结论

右心房血乳酸浓度与肺动脉血乳酸浓度之间的差异可能是由于冠状窦血液中血乳酸浓度较低,因为在此期间它是心肌的重要底物。右心房血氧饱和度与肺动脉血氧饱和度百分比之间缺乏差异表明,鉴于较低的氧消耗,心肌的氧摄取较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a71b/5632970/df7605ad52f3/rbti-29-03-0287-g01.jpg

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