Tydén H, Johansson L, Nyström S O, Westerholm C J
Acta Anaesthesiol Scand. 1979 Oct;23(5):480-92. doi: 10.1111/j.1399-6576.1979.tb01477.x.
The central and peripheral circulation were studied in 12 patients after aortocoronary bypass surgery. During the initial 5 h after termination of cardiopulmonary bypass, the oesophageal temperature rose from 36.5 degrees C to 39.4 degrees C, concomitant with cutaneous vasoconstriction and an increase in systemic vascular resistance (SVR) and mean arterial blood pressure (MABP). The oxygen uptake index (Vo2I) increased by 57% during the rewarming period. The cardiac index (CI), which was constant at 2.8 l.min-1.m-2, was too low to satisfy this oxygen demand and the arterio-venous oxygen content difference (AVDo2) increased to 3.0 mmol . l-1 by the 3rd hour. After 5 h, SVR had decreased and cutaneous vasodilation began. Vo2I and AVDo2 decreased. The postoperative myocardial function was moderately impaired and deteriorated after the cutaneous vasodilation. Twelve patients were given an infusion of sodium nitroprusside during the postoperative period (0.25--2.5 micrograms . kg-1 . min-1). The rewarming pattern was not influenced by this infusion, but the initial increases in MABP and SVR were eliminated. The myocardial performance was better in the nitroprusside group. CI was significantly higher than in the control group (3.5 l.min-1.m-2) and AVDo2 remained normal.
对12例接受主动脉冠状动脉搭桥手术后的患者的中心循环和外周循环进行了研究。在体外循环结束后的最初5小时内，食管温度从36.5℃升至39.4℃，同时伴有皮肤血管收缩以及全身血管阻力（SVR）和平均动脉血压（MABP）升高。在复温期间，氧摄取指数（Vo2I）增加了57%。心脏指数（CI）维持在2.8 l·min-1·m-2不变，过低无法满足这种氧需求，到第3小时动静脉氧含量差（AVDo2）增加到3.0 mmol·l-1。5小时后，SVR下降，皮肤血管舒张开始。Vo2I和AVDo2下降。术后心肌功能有中度损害，在皮肤血管舒张后恶化。12例患者在术后期间接受硝普钠输注（0.25--2.5微克·kg-1·min-1）。这种输注未影响复温模式，但消除了MABP和SVR的最初升高。硝普钠组的心肌性能更好。CI显著高于对照组（3.5 l·min-1·m-2），且AVDo2保持正常。
