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The Annals of Thoracic Surgery, Vol 57, 371-375, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Effect of cardiopulmonary bypass on gastrointestinal perfusion and function

JA Gaer, AD Shaw, R Wild, RI Swift, CM Munsch, PL Smith and KM Taylor
Department of Cardiothoracic Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, London, England.

Gastric mucosal tonometry was used to determine the adequacy of gastrointestinal perfusion in 10 patients undergoing elective myocardial revascularization. Patients were prospectively randomized to receive either pulsatile or nonpulsatile flow during cardiopulmonary bypass. All patients showed a reduction in gastric mucosal perfusion during bypass, manifested by a reduction in the gastric mucosal pH, which occurred independently of variations in the arterial pH. In the group of patients receiving nonpulsatile flow, this reduction was significantly greater (p < 0.05). Cardiopulmonary bypass using nonpulsatile flow is associated with the development of a gastric mucosal acidosis, which may have implications for the development of postoperative complications.


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