Moriyama S, Utoh J, Okamoto K, Hirata T, Kunitomo R, Tanaka M, Kitamura N
First Department of Surgery, Kumamoto University School of Medicine, Japan.
Jpn J Thorac Cardiovasc Surg. 1998 Feb;46(2):164-9. doi: 10.1007/BF03250612.
To evaluate the influence of body temperature during cardiopulmonary bypass (CPB) on postoperative systemic metabolism, 32 patients undergoing elective cardiac surgery were randomly assigned to either hypothermia (n = 16) or normothermia (n = 16). Serial hemodynamic parameters and blood samples were obtained after surgery. CPB and operation times were significantly shorter and the platelet reduction ratio during CPB [ = (platelets before CPB-platelets after CPB)/platelets before CPB] was significantly lower in normothermic patients than in hypothermic patients. The platelet reduction ratio was dependent on the minimum rectal temperature during CPB, the operation time, and the CPB time. In the early postoperative period, hypothermic patients had abnormally high systemic vascular resistance and a reduced cardiac index compared with the normothermic patients. There were no differences between 2 groups in postoperative hepatic and renal functions, changes in oxygen consumption, arterial-venous PCO2 or arterial-venous pH gradient. This study suggested a beneficial influence of normothermic CPB on postoperative hemodynamics. Normothermic CPB was not associated with adverse effects on postoperative metabolic recovery.
为评估体外循环(CPB)期间体温对术后全身代谢的影响,将32例行择期心脏手术的患者随机分为低温组(n = 16)和常温组(n = 16)。术后获取系列血流动力学参数和血样。常温患者的CPB时间和手术时间显著短于低温患者,且CPB期间血小板减少率[ =(CPB前血小板数 - CPB后血小板数)/CPB前血小板数]显著低于低温患者。血小板减少率取决于CPB期间的最低直肠温度、手术时间和CPB时间。术后早期,与常温患者相比,低温患者的全身血管阻力异常升高,心脏指数降低。两组术后肝肾功能、氧耗变化、动静脉PCO2或动静脉pH梯度无差异。本研究提示常温CPB对术后血流动力学有有益影响。常温CPB与术后代谢恢复的不良反应无关。