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Ann Thorac Surg 1994;57:371-375
© 1994 The Society of Thoracic Surgeons

Articles

Effect of cardiopulmonary bypass on gastrointestinal perfusion and function

Jullien A.R. Gaer, FRCSEd*,1, Andrew D.S. Shaw, MB, Rachel Wild, MB, R.Ian Swift, FRCS, Christopher M. Munsch, FRCS, Peter L.C. Smith, FRCS, Kenneth M. Taylor, FRCS

Department of Cardiothoracic Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, London, England

Accepted for publication March 27, 1993.

* Address reprint requests to Mr Gaer, Department of Cardiothoracic Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, Du Cane Rd, London, W12 0NN, England.

Gastric mucosal tonometry was used to determine the adequacy of gastrointestinal perfusion in 10 patients undergoing elective myccardial revascularization. Patients were prospectively randomized to receive either pulsatile or nonpulsatile flow during cardlopulmonary 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 too arterial pH. In the group of patients receiving nonpuisatile flow, this reduction was significantly greater (p < 0.05). Cardiopulmonary bypass using nonpulsatife 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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