Booker P D, Davis A J, Franks R
Royal Liverpool Children's NHS Trust.
Br J Anaesth. 1997 Jul;79(1):14-8. doi: 10.1093/bja/79.1.14.
We have studied gut mucosal perfusion in 24 infants, aged 0.7-45 weeks, requiring cardiopulmonary bypass (CPB). Group 2 patients (n = 12) had received the angiotensin converting enzyme inhibitor captopril 0.8-0.9 mg kg-1 orally, 45 min before induction of anaesthesia. Group 1 infants were of similar age and size and required a similar duration of CPB, but did not receive any preoperative medication. An orogastric tonometer allowed intermittent calculations of gastric intramucosal pH (pHi), and rectal mucosal perfusion ("flux") was monitored using laser Doppler flowmetry. Measurements of arterial base deficit and lactate and pyruvate concentrations were made intermittently. We found no significant difference in femoral arterial pressure between the groups at any time before, during or after surgery. Similarly, we found no significant differences in our measures of regional or global tissue perfusion between the groups at any time before, during or after surgery. We conclude that preoperative administration of captopril produced no beneficial effect on gut mucosal perfusion in infants undergoing hypothermic, non-pulsatile CPB.
我们研究了24例年龄在0.7 - 45周、需要进行体外循环（CPB）的婴儿的肠道黏膜灌注情况。第2组患者（n = 12）在麻醉诱导前45分钟口服了0.8 - 0.9 mg/kg的血管紧张素转换酶抑制剂卡托普利。第1组婴儿年龄和大小相似，CPB持续时间相近，但未接受任何术前用药。通过口胃张力计间歇性计算胃黏膜内pH值（pHi），并使用激光多普勒血流仪监测直肠黏膜灌注（“通量”）。间歇性测量动脉碱缺失以及乳酸和丙酮酸浓度。我们发现在手术前、手术期间或手术后的任何时间，两组之间的股动脉压均无显著差异。同样，我们发现在手术前、手术期间或手术后的任何时间，两组之间在局部或整体组织灌注指标方面均无显著差异。我们得出结论，术前给予卡托普利对接受低温、非搏动性CPB的婴儿的肠道黏膜灌注没有产生有益影响。
