Effect of coronary artery bypass grafting with gastroepiploic artery on gastric intramucosal pH and systemic inflammation.
BACKGROUND
The purpose of this study was to investigate the effect of coronary arterial bypass grafting (CABG) with gastroepiploic artery (GEA) on gastric intramucosal pH and systemic inflammation.


METHODS



METHODS
retrospective study.


METHODS
University hospital.


METHODS
22 patients underwent CABG.


METHODS
the GEA group (n=13) received CABG with the GEA graft. The non-GEA group (n=9) received conventional CABG without the GEA graft.


METHODS
gastric intramucosal pH (pHi) and carbon dioxide tension (PrCO(2)) were assessed by capnometric air tonometry. The difference between PrCO(2) and PaCO(2), PCO(2)-gap, was also determined. Systemic inflammatory responses were evaluated by serum interleukin-6 (IL-6) and leucocyte counts. Hemodynamics, oxygen delivery index (DO(2)I) and uptake index (VO(2)I) were monitored with catheters in the radial and pulmonary arteries (thermodilution).


RESULTS
The duration of aortic cross-clamping and cardiopulmonary bypass was similar in both groups. Both groups did not show any significant difference in gastric pHi, PCO(2)-gap, systemic inflammation and hemodynamics.


CONCLUSIONS
Our findings suggest that CABG using the GEA graft does not disturb gastric mucosal perfusion, and that laparotomy for the GEA graft does not aggravate systemic oxygen demand-supply imbalance or systemic inflammatory responses induced by hypothermic CPB. CABG with the GEA graft does not seem to pose an additional risk and is a safe technique compared with conventional CABG with regard to pHi and systemic inflammation.
Yamaura
K
K
Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ken@mcw.edu
Akiyoshi
K
K
Irita
K
K
Takahashi
S
S
D000368:Aged; D002245:Carbon Dioxide / Q000502:physiology*; D001026:Coronary Artery Bypass; D019074:Epigastric Arteries / Q000637:transplantation*; D005260:Female; D005745:Gastric Acidity Determination; D005753:Gastric Mucosa / Q000503:physiopathology*; D006085:Graft Survival; D006439:Hemodynamics; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007249:Inflammation / Q000097:blood / Q000503:physiopathology*; D015850:Interleukin-6 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption
D015850:Interleukin-6; D002245:Carbon Dioxide