Gastric intramucosal perfusion during descending aortic repair under femoro-femoral bypass.
The changes in gastric mucosal perfusion during distal aortic perfusion with femoro-femoral bypass (F-F bypass) were assessed by air-automated gastric tonometry. A prospective study was performed in six patients who underwent descending aortic surgery for aortic aneurysm under F-F bypass with mild hypothermia (34 degrees C). Gastric intramucosal pH (pHi) and PaCO2-PgCO2 gap (PCO2 gap) were measured. Data are presented as means and standard deviations and analyzed by using one-way analysis of variance followed by Scheffe test. Perioperative variables of hepatorenal functions are also evaluated. The PCO2 gap significantly increased during F-F bypass (3.0 +/- 2.1 mm Hg at control, 14.2 +/- 5.5 mm Hg during F-F bypass; p = 0.004), indicating abnormal gastric mucosal perfusion during F-F bypass. Significantly low pHi was found at weaning from F-F bypass (7.35 +/- 0.05 at control, 7.21 +/- 0.10 at weaning; p = 0.009), which might be related to progressing systemic metabolic acidosis. No impairment of hepatorenal functions was observed after the surgery. Distal perfusion with F-F bypass during descending aortic surgery could impair the gastric mucosal perfusion, but may have little effect on postoperative visceral dysfunction.
Tachibana
Kaori
K
Department of Anesthesiology and Critical Care Medicine, Hokkaido University Graduate School of Medicine, Kita-15, Nishi-7, Sapporo 060-8638, Japan.
Hisano
Kenjiro
K
Sakuraya
Fumika
F
Tang
Sijian
S
Shiiya
Norihiko
N
Hashimoto
Toshikazu
T
Takita
Koichi
K
Morimoto
Yuji
Y
D000368:Aged; D000704:Analysis of Variance; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001784:Blood Gas Analysis; D002245:Carbon Dioxide / Q000097:blood; D001026:Coronary Artery Bypass / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005745:Gastric Acidity Determination; D005753:Gastric Mucosa / Q000378:metabolism*; D006801:Humans; D008297:Male; D008365:Manometry; D008875:Middle Aged; D010477:Perfusion; D011446:Prospective Studies
D002245:Carbon Dioxide