Llagunes-Herrero J, Català-Bauset J C, Marín-Pardo P, Mateo-Rodríguez E, Aguar-Olba F, Palanca-San Francisco J M, Grau-Real F, Aznar-Vicente J
Servicio de Anestesiología y Reanimación, Hospital General Universitario, Valencia.
Rev Esp Anestesiol Reanim. 1997 Dec;44(10):388-91.
To evaluate the monitoring of intramucosal pH (pHi) and standard pH (pHs) during heart surgery with extracorporeal circulation (ECC) and moderate hypothermia. The correlations of pHi and pHs and the postoperative APACHE III score after surgery were analyzed.
Sixteen patients with cardiac output > 0.4 scheduled for coronary bypass surgery, or aortic or mitral valve replacement were studied. Arterial pH (pHa), pHi and pHs were measured and the difference between pHa and pHi was calculated before starting ECC (T0), during ECC and hypothermia (T1) and after termination of ECC (T2). The APACHE III score was recorded 18 h after surgery.
No significant differences between the pHi and pHs were observed in these patients. pHi was significantly higher during ECC with hypothermia (T1) than at baseline (T0). pHi and pHs were significantly correlated during the study period. There was no correlation between the APACHE III score in the immediate postoperative period and either pHi or pHs during surgery.
Periods of splanchnic hypoxia (pHi < 7.32) during heart surgery with moderate hypothermia were not seen in patients with cardiac output > 0.4. pHs is a reliable measurement of pHi. There is no relation between APACHE III scores in the early postoperative period and pHi or pHs levels during surgery.
评估在体外循环（ECC）和中度低温心脏手术期间对黏膜内pH值（pHi）和标准pH值（pHs）的监测情况。分析pHi和pHs之间的相关性以及术后APACHE III评分。
研究了16例心输出量>0.4且计划进行冠状动脉搭桥手术、主动脉或二尖瓣置换术的患者。在开始ECC前（T0）、ECC及低温期间（T1）和ECC结束后（T2）测量动脉pH值（pHa）、pHi和pHs，并计算pHa与pHi之间的差值。术后18小时记录APACHE III评分。
这些患者的pHi和pHs之间未观察到显著差异。在伴有低温的ECC期间（T1），pHi显著高于基线水平（T0）。在研究期间，pHi和pHs显著相关。术后即刻的APACHE III评分与手术期间的pHi或pHs均无相关性。
心输出量>0.4的患者在中度低温心脏手术期间未出现内脏缺氧期（pHi<7.32）。pHs是pHi的可靠测量指标。术后早期的APACHE III评分与手术期间的pHi或pHs水平无关。
