[Metabolic monitoring of heart surgery patients during the immediate postoperative period].
The situation of aggression is accompanied by metabolic alterations with an important neuro-endocrinal context. Extracorporeal surgery is an especially aggressive situation which involves both surgery and the added metabolic state of hypothermia. In 48 patients subjected to extracorporeal circulation with hypothermia, the metabolic parameters of Oxygen Consumption (VO2), Production of carbon dioxide (VCO2), Respiratory Quotient (RQ) and Energy Expenditure (GE) were studied. It was observed that the patients could be divided into two subgroups, depending on their metabolic response. Studying the RQ parameter, it was seen that this divided patients into two subgroups depending on their posterior evolution. Patients in whom RQ did not exceed 0.8 showed more favourable evolution than those in whom RQ was higher than 0.8. The correct metabolic response was regarded as a parameter indicative of the evolution, directly correlated to the hemodynamic parameters studied. In one patient, creatine phosphate was infused at a dosage of 30 mg/kg for 60 min, and an improvement was noted in GE and Cardiac Index. It was concluded that the intravenous intake of creatine phosphate in patients undergoing extracorporeal surgery improved both metabolic parameters and the myocardiac function.
Smirnova
V I
VI
Instituto Vishnevski de Cirugía, Academia de Ciencias Médicas de la URSS, Moscú, URSS.
Machulin
A V
AV
Pulina
N N
NN
Solopova
G V
GV
D000328:Adult; D006348:Cardiac Surgical Procedures; D004734:Energy Metabolism; D005112:Extracorporeal Circulation; D005260:Female; D006321:Heart / Q000187:drug effects; D006439:Hemodynamics; D006801:Humans; D007036:Hypothermia, Induced; D008297:Male; D008660:Metabolism / Q000187:drug effects; D008991:Monitoring, Physiologic; D010101:Oxygen Consumption; D010725:Phosphocreatine / Q000008:administration & dosage / Q000494:pharmacology; D011184:Postoperative Period; D013312:Stress, Physiological / Q000378:metabolism* / Q000503:physiopathology
D010725:Phosphocreatine