title: Effect of coronary artery bypass grafting with gastroepiploic artery on gastric intramucosal pH and systemic inflammation.
abstract: 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.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. ken@mcw.edu
authors.forename: K
authors.initials: K
authors.lastname: Yamaura
authors.forename: K
authors.initials: K
authors.lastname: Akiyoshi
authors.forename: K
authors.initials: K
authors.lastname: Irita
authors.forename: S
authors.initials: S
authors.lastname: Takahashi
mesh_terms: 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
chemical_list: D015850:Interleukin-6; D002245:Carbon Dioxide