Hormonal and metabolic responses of fetal lamb during cardiopulmonary bypass.
OBJECTIVE
To study the hormonal and metabolic responses of fetal lamb during cardiopulmonary bypass.


METHODS
Six pregnant ewes underwent fetal cardiopulmonary bypasses with artificial oxygenators and roller pumps for 30 minutes, which maintained the blood gas value at the fetal physiological level. The fetal blood pressure, heart rate, pH value and blood lactate levels were monitored. The levels of catecholamine, cortisol and insulin were measured pre-bypass and then again 30 minutes later. The blood glucose and free fatty acid levels were monitored continuously during the bypass. Fetal hepatic PAS staining was also carried out.


RESULTS
There were no changes before and during the bypass in fetal blood pressure, heart rate and blood gas. However, pH values decreased and blood lactate levels increased (P < 0.05). The fetal catecholamine and cortisol levels increased significantly (P < 0.01), while the levels of insulin did not change. The blood glucose and free fatty acid levels increased at the beginning of the bypass (P < 0.01), and then gradually slowed down during the bypass. The fetal hepatic PAS staining showed that hepatic glycogen was consumed in large amounts. After 30 minutes of bypass, the fetal lamb would not survive more than 1 hour.


CONCLUSIONS
The fetal lamb has a strong negative reaction to cardiopulmonary bypass.
Su
Zhaokang
Z
Department of Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, Shanghai Second Medical University, Shanghai 200127, China.
Zhou
Chengbin
C
Zhang
Haibo
H
Zhu
Zhongqun
Z
D000818:Animals; D001784:Blood Gas Analysis; D001786:Blood Glucose / Q000032:analysis*; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D002395:Catecholamines / Q000097:blood*; D005230:Fatty Acids, Nonesterified / Q000097:blood*; D005333:Fetus / Q000502:physiology*; D006439:Hemodynamics / Q000502:physiology; D006854:Hydrocortisone / Q000097:blood*; D007773:Lactates / Q000097:blood*; D012756:Sheep
D001786:Blood Glucose; D002395:Catecholamines; D005230:Fatty Acids, Nonesterified; D007773:Lactates; D006854:Hydrocortisone