[pH调节在深度低温和循环骤停中的作用[作者简介]。

H Becker, J Vinten-Johansen, J V Maloney, G D Buckberg
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引用次数: 0

摘要

在14只幼犬中,通过表面低温将体温降至22摄氏度,然后通过体外循环将体温降至16摄氏度。在60分钟的循环停止期间,所有心脏都用相同的多剂量血液停搏液保护。其中7只狗的pH值保持在7.4,另外7只狗的pH值像变温动物一样(即16摄氏度时的7.95),主要是通过在冷却和再加热过程中调节二氧化碳分压来改变的。适当的pH调节可以在正常全身乳酸代谢的情况下提高心输出量。通过将二氧化碳分压降低到10毫米汞柱来提高pH值,可以使脑血流量增加一倍。当pH值保持在7.4时,心肌功能下降50%,当pH值适当变化时,心肌功能恢复正常。这些发现对心脏手术期间低温的常规管理具有重要意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Effect of pH adjustment in deep hypothermia and circulatory arrest (author's transl)].

In 14 puppies, body temperature was lowered to 22 degrees C with surface hypothermia, then to 16 degrees C with textracorporeal circulation. During 60 min of circulatory arrest all hearts were protected with the same multidose blood cardioplegic solution. In seven dogs pH was kept at 7.4 and in seven others pH was varied as in poikilotherms (i.e. 7.95 at 16 degrees C) principally by adjusting pCO2 during cooling and rewarming. Appropriate pH adjustment allowed higher cardiac output with normal systemic lactate metabolism. Raising pH by lowering pCO2 to 10 mm Hg allowed twice as much cerebral blood flow. Postischemic myocardial performance was depressed by 50% by retaining pH 7.4 and was normal when pH was varied appropriately. These findings have major implications for the routine management of hypothermia during cardiac operations.

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