The response of the vascular beds to sodium bicarbonate in patients during normothermic bypass.
OBJECTIVE
Cardiopulmonary bypass (CPB) provides a unique circumstance to study the effects of drugs on the systemic vasculature. Thus, this study was designed to evaluate the effects of sodium bicarbonate on the systemic circulation during CPB in humans.


METHODS
Randomized, double-blind study.


METHODS
Tertiary care university hospital.


METHODS
Patients presenting for coronary artery bypass graft surgery with CPB.


METHODS
In this double-blind study, 22 consecutive adult patients of both sexes undergoing cardiac surgery were randomized into 2 groups. After establishing CPB and cardioplegia, patients in group 1 (n = 11) received saline (0.9%) (1.2 mL/kg), and group 2 received sodium bicarbonate (SB) (7%) (1.2 mL/kg). The blood level in the cardiotomy reservoir, pump flow, and mean arterial pressure were measured for 25 minutes.


RESULTS
The SB-treated patients (group 2) showed significantly greater (p < 0.05) decreases in cardiotomy reservoir blood volume (336 +/- 186 mL) than the saline-treated (140 +/- 97 mL) patients. The mean arterial pressure in group 2 patients significantly (p < 0.05) increased (from 49 +/- 11.9 to 65 +/- 5.3 mmHg) more than in the saline group (from 50 +/- 6.8 to 57 +/- 9.2 mmHg) after 20 minutes. The decrease in reservoir volume significantly (p < 0.05) and inversely correlated (r = -0.61) with the acidotic state of the patients before SB.


CONCLUSIONS
This study found a biphasic response to SB on the systemic circulation during CPB. Early dilation of venous capacitance vessels occurred followed by arteriolar constriction over the 20-minute study interval.
Tripathi
Mukesh
M
Department of Anesthesiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Singh
Prabhat K
PK
Nath
Soumya S
SS
Singh
Uttam
U
D000293:Adolescent; D000328:Adult; D000368:Aged; D001775:Blood Circulation / Q000187:drug effects* / Q000502:physiology; D001783:Blood Flow Velocity / Q000187:drug effects / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001810:Blood Volume / Q000187:drug effects / Q000502:physiology; D001831:Body Temperature / Q000187:drug effects* / Q000502:physiology; D002315:Cardiopulmonary Bypass / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017693:Sodium Bicarbonate / Q000494:pharmacology*
D017693:Sodium Bicarbonate