The effects of colloidal and crystalloidal fluids on acidosis and lactacidemia in cardiopulmonary bypass.
During extracorporeal cardiac surgery it is difficult to measure the severity of metabolic acidosis thru arterial bloods gas determination. During bypass surgery a decrease in Colloidosmotic Pressure (COP) may influence the degree of acidosis. We studied 90 patients in whom the following parameters were measured before, 30 minutes after beginning bypass, immediatly after bypass, upon arriving bypass, upon arriving in the Intensive Care Unit (ICU) and upon discharge (ICU): pH, lactic, acid, pO2, pCO2, base excess correlating them with COP. There is a relation between COP and lactic acid, COP = 21.39-0.17 Lactic Acid, with p < 0.001. There is a inverse lineal correlation between COP and blood lactic acid levels. A greater COP was found with a lower blood lactic acid levels. We recommend the use of colloids perfusion as priming fluid instead of electrolytes solutions, specially in patients in extreme ages and also in those in whom a prolonged bypass time is foreseen. This may prevent an increase in blood lactic acid levels.
Zabala
M S
MS
Servicio de Cirugía Cardiovascular y Torácica, Clínica Universitaria de Navarra, Pamplona, Spain.
Leombruni
E
E
Di Stefano
S
S
D000140:Acidosis, Lactic / Q000209:etiology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D002315:Cardiopulmonary Bypass; D002648:Child; D003102:Colloids / Q000008:administration & dosage; D006801:Humans; D007432:Intraoperative Period; D007773:Lactates / Q000097:blood*; D019344:Lactic Acid; D008875:Middle Aged; D009997:Osmotic Pressure; D012044:Regression Analysis
D003102:Colloids; D007773:Lactates; D019344:Lactic Acid