Open heart surgery; pump prime effects and cerebral arteriovenous differences in glucose, lactate and ketones

This study included 17 young children, who were operated with cardioplumonary bypass for congenital heart defects and were cooled to 20 degrees C or 25 degrees C. No glucose, except for the pump prime solution, was administered during surgery. Samples of arterial blood, cerebral venous blood from th...

Full description

Saved in:
Bibliographic Details
Published in:Pediatric anesthesia 1999, Vol.9 (1), p.53-59
Main Authors: SANDSTRÖM, K, NILSSON, K, ANDREASSON, S, LARSSON, L. E
Format: Article
Language:English
Subjects:
Analysis of Variance
Biological and medical sciences
Blood Glucose - analysis
Body Temperature
Brain - metabolism
Cardiopulmonary Bypass - instrumentation
Cardiopulmonary Bypass - methods
Cerebral Arteries
Cerebral Veins
Child, Preschool
Gluconeogenesis
Heart Defects, Congenital - surgery
Humans
Hypothermia, Induced
Isotonic Solutions
Jugular Veins
Ketones - blood
Ketones - metabolism
Lactates - blood
Lactates - metabolism
Linear Models
Medical sciences
Oxygen - blood
Oxygen Consumption
Rewarming
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:This study included 17 young children, who were operated with cardioplumonary bypass for congenital heart defects and were cooled to 20 degrees C or 25 degrees C. No glucose, except for the pump prime solution, was administered during surgery. Samples of arterial blood, cerebral venous blood from the jugular bulb and mixed venous blood from the bypass circuit were obtained and analysed for concentrations of glucose, lactate and ketones as well as oxygen saturation. The prime content of lactate significantly contributed to the arterial lactate concentrations, which together with the cerebral arteriovenous (A-V) lactate differences remained elevated throughout the bypass period. The prime content of glucose had less influence on the arterial concentrations and these did not increase until the rewarming period, when indications of gluconeogenesis from lactate were found. Arterial ketone concentrations also increased during rewarming in parallel with significant cerebral uptake of ketones. The lowest cerebral A-V glucose, lactate and oxygen saturation differences were found at the target minimum temperature and this effect was significantly more pronounced in the patients cooled to 20 degrees C.
ISSN:1155-5645
1460-9592
DOI:10.1046/j.1460-9592.1999.00308.x