Yasuda T, Kawasuji M, Sakakibara N, Takemura H, Matsumoto Y, Ushijima T, Fujii S, Watanabe Y
Department of Surgery (I), Kanazawa University School of Medicine, Japan.
Kyobu Geka. 1995 Nov;48(12):993-6.
The effect of systemic temperature during cardiopulmonary bypass (CPB) surgery was evaluated in 100 patients. The patients were divided into three groups, based on systemic temperature during CPB; 28 degrees C, 30 degrees C, or 32 degrees C (tepid). Multidose cold crystalloid cardioplegia was administered for myocardial protection. Pump flow was maintained at 75 ml/kg/min. Methoxamine hydrochloride and phenothiazine were used to maintain systemic perfusion pressures between 60 and 80 mmHg. Preoperatively, there were no differences between groups in left ventricular ejection fraction or extent of coronary artery disease. The time required for CPB and weaning from CPB were significantly shorter in the 32 degrees C group than in either the 28 degrees C or the 30 degrees C group. There were significant differences in the doses of methoxamine hydrochloride and phenothiazine required in each group. Postoperatively, there were no significant differences in the incidence of myocardial infarction, stroke, or 30-day mortality between groups. In conclusion, tepid systemic perfusion shortens the length of CPB and does not differ significantly from cold perfusion with respect to mortality and morbidity.
在100例患者中评估了体外循环（CPB）手术期间全身温度的影响。根据CPB期间的全身温度，将患者分为三组：28摄氏度、30摄氏度或32摄氏度（微温）。采用多剂量冷晶体心脏停搏液进行心肌保护。泵流量维持在75毫升/千克/分钟。使用盐酸美索明和吩噻嗪将全身灌注压维持在60至80毫米汞柱之间。术前，各组之间在左心室射血分数或冠状动脉疾病程度方面无差异。CPB及脱离CPB所需时间在32摄氏度组明显短于28摄氏度组和30摄氏度组。每组所需的盐酸美索明和吩噻嗪剂量存在显著差异。术后，各组之间在心肌梗死、中风或30天死亡率的发生率方面无显著差异。总之，微温全身灌注可缩短CPB时间，在死亡率和发病率方面与冷灌注无显著差异。
