ATS
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ohri, S. K.
Right arrow Articles by Taylor, K. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ohri, S. K.
Right arrow Articles by Taylor, K. M.

The Annals of Thoracic Surgery, Vol 57, 1193-1199, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Effects of cardiopulmonary bypass on gut blood flow, oxygen utilization, and intramucosal pH

SK Ohri, J Becket, J Brannan, BE Keogh and KM Taylor
Department of Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom.

Studies documenting rises in endotoxin after cardiopulmonary bypass (CPB) have postulated gut mucosal hypoperfusion. We have investigated alterations in jejunal blood flow by laser Doppler flow measurement, intramucosal pH (pHi) by tonometry, and oxygen utilization in a canine model of hypothermic CPB (n = 11 dogs). After 10 minutes of hypothermic CPB, despite no major reduction in superior mesenteric artery flow, mucosal laser Doppler flow decreased to -38.2% +/- 9.3% of levels obtained before bypass (p = 0.008) and serosal laser Doppler flow, to - 47.3% +/- 11.4% (p = 0.006). During the hypothermic phase, mesenteric oxygen consumption fell from 0.18 +/- 0.01 to 0.098 +/- 0.01 mL.min- 1.kg-1 (p = 0.005), and mesenteric oxygen delivery fell from 1.97 +/- 0.39 to 1.14 +/- 0.12 mL.min-1.kg-1 (p = 0.05). There was no change in jejunal pHi. During the rewarming phase, there was a substantial increase in mucosal laser Doppler flow, peaking at +69.8% +/- 15.2% (p = 0.03), whereas serosal laser Doppler flow returned to values seen prior to CPB (-16.4% +/- 21.5%; p = 0.25). These changes coincided with a surge in oxygen consumption (0.33 +/- 0.042 mL.min-1.kg-1; p = 0.009), while mesenteric oxygen delivery remained depressed at 1.09 +/- 0.12 mL.min-1.kg-1 (p = 0.04). Jejunal pHi fell from a value of 7.36 +/- 0.04 before CPB to 7.12 +/- 0.07 (p = 0.02), thus indicating mucosal hypoxia. During the rewarming phase of hypothermic CPB, there is a disparity between mesenteric oxygen consumption and oxygen delivery with villus tip ischemia; these findings may explain the pathophysiology of endotoxemia during CPB.


This article has been cited by other articles:


Home page
 Am. J. Physiol. Regul. Integr. Comp. Physiol.Home page
M. Hultstrom, L. Jansson, B. Bodin, and O. Kallskog
Moderate hypothermia induces a preferential increase in pancreatic islet blood flow in anesthetized rats
Am J Physiol Regulatory Integrative Comp Physiol, September 1, 2007; 293(3): R1438 - R1443.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
T. A. Khan, C. Bianchi, M. Ruel, J. Feng, and F. W. Sellke
Differential effects on the mesenteric microcirculatory response to vasopressin and phenylephrine after cardiopulmonary bypass
J. Thorac. Cardiovasc. Surg., March 1, 2007; 133(3): 682 - 688.
[Abstract] [Full Text] [PDF]

Home page
 PerfusionHome page
S. K Ohri and T. Velissaris
Gastrointestinal Dysfunction Following Cardiac Surgery
Perfusion, July 1, 2006; 21(4): 215 - 223.
[PDF]

Home page
 ICVTSHome page
H. J. Geissler, U. M. Fischer, S. Grunert, F. Kuhn-Regnier, A. Hoelscher, R. H.G. Schwinger, U. Mehlhorn, and K. Hekmat
Incidence and outcome of gastrointestinal complications after cardiopulmonary bypass
Interactive CardioVascular and Thoracic Surgery, June 1, 2006; 5(3): 239 - 242.
[Abstract] [Full Text] [PDF]

Home page
 PerfusionHome page
J. Li, J. Stokoe, I. E Konstantinov, R. K Kharbanda, and A. N Redington
Evidence for a significant myocardial contribution to total metabolic burden during hypothermic cardiopulmonary bypass: a study of continuously measured oxygen consumption and arterial lactate levels in pigs
Perfusion, September 1, 2005; 20(5): 277 - 283.
[Abstract] [PDF]

Home page
 Biol Res NursHome page
E. M. Fisher, M. E. Kerr, L. A. Hoffman, R. P. Steiner, and R. A. Baranek
A Comparison of Gastric and Rectal CO2 in Cardiac Surgery Patients
Biol Res Nurs, April 1, 2005; 6(4): 268 - 280.
[Abstract] [PDF]

Home page
 PerfusionHome page
M. A Sobieski II, M. S Slaughter, D. E Hart, P. S Pappas, and A. J Tatooles
Prospective study on cardiopulmonary bypass prime reduction and its effect on intraoperative blood product and hemoconcentrator use
Perfusion, January 1, 2005; 20(1): 31 - 37.
[Abstract] [PDF]

Home page
 SEMIN CARDIOTHORAC VASC ANESTHHome page
E. A. Hessel II
Abdominal Organ Injury After Cardiac Surgery
Seminars in Cardiothoracic and Vascular Anesthesia, September 1, 2004; 8(3): 243 - 263.
[Abstract] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
M. Jormalainen, A. E. Vento, U. Wartiovaara-Kautto, R. Suojaranta-Ylinen, O. J. Ramo, and J. Petaja
Recombinant hirudin enhances cardiac output and decreases systemic vascular resistance during reperfusion after cardiopulmonary bypass in a porcine model
J. Thorac. Cardiovasc. Surg., August 1, 2004; 128(2): 189 - 196.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
F. Doguet, P.-Y. Litzler, F. Tamion, V. Richard, M.-F. Hellot, C. Thuillez, A. Tabley, F. Bouchart, and J. P. Bessou
Changes in mesenteric vascular reactivity and inflammatory response after cardiopulmonary bypass in a rat model
Ann. Thorac. Surg., June 1, 2004; 77(6): 2130 - 2137.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
S. M. Jakob
Splanchnic Blood Flow in Low-Flow States
Anesth. Analg., April 1, 2003; 96(4): 1129 - 1138.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
W. J. Gomes, M. R. Erlichman, M. L. Batista-Filho, M. Knobel, D. R. Almeida, A. C. Carvalho, R. Catani, and E. Buffolo
Vasoplegic syndrome after off-pump coronary artery bypass surgery
Eur. J. Cardiothorac. Surg., February 1, 2003; 23(2): 165 - 169.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
R.V. Venkateswaran, S.C. Charman, M. Goddard, and S.R. Large
Lethal mesenteric ischaemia after cardiopulmonary bypass: a common complication?
Eur. J. Cardiothorac. Surg., October 1, 2002; 22(4): 534 - 538.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
A. Thoren, M. Elam, and S.-E. Ricksten
Jejunal Mucosal Perfusion Is Well Maintained During Mild Hypothermic Cardiopulmonary Bypass in Humans
Anesth. Analg., January 1, 2001; 92(1): 5 - 11.
[Abstract] [Full Text] [PDF]

Home page
 PerfusionHome page
V. Videm, J. L Svennevig, E. Fosse, B. Mohr, and A. O Aasen
Plasma endotoxin concentrations during cardiac surgery may be related to atherosclerosis
Perfusion, September 1, 2000; 15(5): 421 - 426.
[Abstract] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. Sungurtekin, U. S. Boston, T. A. Orszulak, and D. J. Cook
Effect of cerebral embolization on regional autoregulation during cardiopulmonary bypass in dogs
Ann. Thorac. Surg., April 1, 2000; 69(4): 1130 - 1134.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Tofukuji, G. L. Stahl, C. Metais, M. Tomita, A. Agah, C. Bianchi, M. P. Fink, and F. W. Sellke
Mesenteric dysfunction after cardiopulmonary bypass: role of complement C5a
Ann. Thorac. Surg., March 1, 2000; 69(3): 799 - 807.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
D. J. Cook
Changing Temperature Management for Cardiopulmonary Bypass
Anesth. Analg., June 1, 1999; 88(6): 1254 - 1254.
[Full Text] [PDF]

Home page
 PerfusionHome page
A. Hamulu, Y. Atay, T. Ya'gdi, B. Discigil, T. Bakalim, S. Buket, and O. Bilkay
Effects of flow types in cardiopulmonary bypass on gastric intramucosal pH
Perfusion, March 1, 1998; 13(2): 129 - 135.
[Abstract] [PDF]

Home page
 PerfusionHome page
S. K Ohri
Systemic inflammatory response and the splanchnic bed in cardiopulmonary bypass
Perfusion, May 1, 1996; 11(3): 200 - 212.
[PDF]

Home page
 Ann. Thorac. Surg.Home page
M. Miyama, W. C. Dihmis, P. H. Deleuze, Y. Uozaki, S. L. Bambang, F. Pasteau, N. Rostaqui, and D. Y. Loisance
The Gastrointestinal Tract: An Underestimated Organ as Demonstrated in an Experimental LVAD Pig Model
Ann. Thorac. Surg., March 1, 1996; 61(3): 817 - 822.
[Abstract] [Full Text]

Home page
 Ann. Thorac. Surg.Home page
P. G. M. Jansen, H. t. Velthuis, E. R. Bulder, R. Paulus, M. R. M. Scheltinga, L. Eijsman, and C. R. H. Wildevuur
Reduction in Prime Volume Attenuates the Hyperdynamic Response After Cardiopulmonary Bypass
Ann. Thorac. Surg., September 1, 1995; 60(3): 544 - 549.
[Abstract] [Full Text]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
W. Tao, J. B. Zwischenberger, T. T. Nguyen, R. A. Vertrees, L. B. McDaniel, L. K. Nutt, D. N. Herndon, and G. C. Kramer
Gut mucosal ischemia during normothermic cardiopulmonary bypass results from blood flow redistribution and increased oxygen demand
J. Thorac. Cardiovasc. Surg., September 1, 1995; 110(3): 819 - 828.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 1994 by The Society of Thoracic Surgeons.