title: [Systemic oxygen demand and supply balance during warm heart surgery without blood transfusion].
abstract: We investigated systemic oxygen demand and supply balance during warm heart surgery without blood transfusion on 203 patients. The patients aged 63-years on average, for coronary artery bypass surgery, were assigned to extracorporeal circulation (ECC) with flow index of either 2.4 l.min-1.m-2 or 2.6. Hemoglobin concentration (Hb), mixed venous oxygen saturation (SvO2), cardiac index (CI), oxygen delivery (DO2), oxygen consumption (VO2) and oxygen extraction ratio (OER) were determined. The mean operation time was 314 min, and the mean ECC time was 94 min. In both groups, the initiation of ECC decreased Hb to 6.5 g.dl-1, and SVO2 decreased gradually during ECC. In addition, DO2 was lower than the pre-ECC level, which may indicate the shortage of oxygen supply, while VO2 and OER increased during ECC. OER increased by 0.38 in the group with flow index of 2.4, which is higher than 0.35 of the group with 2.6. The discontinuation of ECC improved oxygen profile, mainly due to the increase of Hb and CI. These findings indicate that oxygen demand and supply balance was maintained during normothermic ECC without transfusion, although longer duration o ECC may cause the shortage of oxygen supply. A higher flow may be required during normothermic ECC.
authors.affiliation: Department of Anesthesia, Shin Tokyo Hospital, Matsudo.
authors.forename: A
authors.initials: A
authors.lastname: Konishi
authors.forename: K
authors.initials: K
authors.lastname: Kikuchi
authors.forename: M
authors.initials: M
authors.lastname: Sanui
mesh_terms: D000769:Anesthesia, Inhalation; D001803:Blood Transfusion; D001831:Body Temperature; D002302:Cardiac Output; D001026:Coronary Artery Bypass; D005112:Extracorporeal Circulation / Q000009:adverse effects; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D010101:Oxygen Consumption
chemical_list: D006454:Hemoglobins