[动脉酮体比作为心脏手术中氧代谢参数的意义]。

H Kiyama
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引用次数: 0

摘要

心脏手术后过程的特点是细胞需氧量逐渐增加,氧气供应有限。在心脏手术中,必须评估组织氧合是否充足,并迅速纠正氧合不足。本研究旨在探讨心脏外科手术中动脉酮体比(AKBR)与血氧供需关系的关系。在体外循环(CPB)术前、术中及术后的10个时间段,我们测量了43例心内直视手术患者的耗氧量、供氧量、抽氧量、混合静脉氧饱和度、乳酸、乳酸/丙酮酸(L/P)和AKBR。CPB开始后,AKBR立即显著下降,并比乳酸和L/P更快地恢复到CPB前水平。几个时期的AKBR与延迟期的乳酸和L/P显著相关。CPB期间和后AKBR与L/P有显著相关。耗氧量、抽氧量、混合静脉血氧饱和度、乳酸与AKBR有显著相关性。但氧代谢参数与乳酸和L/P均无相关性。总之,从这些数据来看,心脏手术中的AKBR可能有助于作为估计厌氧程度的快速指南。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Significance of arterial ketone body ratio as a parameter of oxygen metabolism in cardiac surgery].

Postoperative course after cardiac surgery is characterized by a progressive increased cellular oxygen demand and limited oxygen supply. It is mandatory to assess the adequacy of tissue oxygenation and to correct inadequate oxygenation rapidly in cardiac surgery. The present study was designed to evaluate the relationship between the arterial ketone body ratio (AKBR) and the status of oxygen demand and supply relationship in cardiac surgery. We measured oxygen consumption, oxygen delivery, oxygen extraction, mixed venous oxygen saturation, lactate, lactate/pyruvate (L/P) and AKBR in 43 patients undergoing open heart surgery at selected 10 periods before, during and after cardiopulmonary bypass (CPB). AKBR significantly decreased immediately after the beginning of CPB and returned to pre-CPB level more quickly than lactate and L/P did. AKBR at several periods a significant correlation with lactate and L/P at delayed periods. There was a significant correlation between AKBR and L/P during and after CPB. Furthermore, oxygen consumption, oxygen extraction, mixed venous oxygen saturation, and lactate were correlated with AKBR significantly. But there was no correlation between the parameter of oxygen metabolism and both lactate and L/P. In conclusion, it appears from these data that AKBR in cardiac surgery may be helpful as a rapid guide for estimating the degree of anaerobiosis.

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