title: Cold intermittent cardioplegia reduces the acidosis during prolonged cardiac surgery with cardiopulmonary bypass.
abstract: The effect on acid-base balance efficacy of intermittent warm and cold blood cardioplegia (IWBC, ICBC) was assessed in 44 patients who underwent cardiac surgery with prolonged aortic cross clamping. With this purpose a customized multi sensor probe was inserted in the coronary sinus, and pH, PO(2), PCO(2) and temperature were continuously measured at 1 Hz sampling rate. The mean cross-clamping time was of 76 ± 26 min on 19 IWBC cases and of 80 ± 24 min on 14 ICBC cases. With IWBC perfusion, at the end of every ischemic period, the lowest pH and PO(2) progressively decreased and the maximal PCO(2) increased. During ICBC the minimum of pH and PO(2) and maximum of PCO2 at the end of different ischemic period during time were constant, also during long cross-clamping time. With IWBC, myocardial ischemia seemed not completely reversed by standardized reperfusions, as reflected by steady deterioration of PCO(2) and pH after each reperfusion.
authors.affiliation: Department of Physics, University of Trento. nollo@science.unitn.it
authors.forename: Giandomenico
authors.initials: G
authors.lastname: Nollo
authors.forename: Paolo
authors.initials: P
authors.lastname: Ferrari
authors.forename: Angelo C
authors.initials: AC
authors.lastname: Graffigna
mesh_terms: D000138:Acidosis / Q000473:pathology*; D000368:Aged; D002245:Carbon Dioxide; D002315:Cardiopulmonary Bypass / Q000379:methods*; D050377:Cold Ischemia / Q000379:methods*; D003250:Constriction; D003710:Demography; D005260:Female; D006324:Heart Arrest, Induced / Q000379:methods*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D010313:Partial Pressure; D052096:Warm Ischemia
chemical_list: D002245:Carbon Dioxide