Olinger G N, Bonchek L I
Ann Thorac Surg. 1978 Dec;26(6):525-34. doi: 10.1016/s0003-4975(10)62939-6.
Although the physiological benefits of left ventricular venting during cardiopulmonary bypass have been documented experimentally, air embolus is still a concern clinically, and surgeons, therefore, continue to debate whether or not to vent routinely during coronary revascularization. In this study, 10 patients vented during revascularization and 10 not vented were studied immediately before and after cardiopulmonary bypass using Sarnoff ventricular function curves to assess changes in ventricular performance. Stroke work index by each patient before and after bypass was compared at common left atrial pressures and concomitant similar systemic resistances. In patients who were vented, there was overall no change in function (98 +/- 7% of control; range, 146--73%). In patients who were not vented, there was overall significant depression of function (67 +/- 5% of control; range, 91--45%, p less than 0.01). The overall absence of depression in patients who were vented, several of whom had very poor ventricles before bypass, strongly supports venting for coronary revascularization.
尽管体外循环期间左心室排气的生理益处已通过实验得到证实，但空气栓塞在临床上仍是一个令人担忧的问题，因此，外科医生仍在就是否在冠状动脉血运重建期间常规排气展开争论。在本研究中，对10例在血运重建期间排气的患者和10例未排气的患者在体外循环前后立即进行了研究，使用萨诺夫心室功能曲线评估心室功能的变化。在相同的左心房压力和伴随的相似体循环阻力下，比较了每位患者体外循环前后的每搏功指数。排气的患者功能总体无变化（为对照的98±7%；范围为146 - 73%）。未排气的患者功能总体显著降低（为对照的67±5%；范围为91 - 45%，p<0.01）。排气的患者总体未出现功能降低，其中几例在体外循环前心室功能很差，这有力地支持了在冠状动脉血运重建时进行排气。
