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Ann Thorac Surg 2007;84:855-856
© 2007 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Invited commentary

Marshall L. Jacobs, MD

Section of Cardiothoracic Surgery, St. Christopher’s Hospital for Children, Erie Ave at Front St, Philadelphia, PA 19134-1095

(Email: marshall.jacobs@tenethealth.com).

The first 20% of the full text of this article appears below.

Dahlbacka and associates [1] have once again made an important contribution to the ever increasing body of knowledge concerning the potential significance of arterial blood gas and pH management strategies during cardiopulmonary bypass. Specifically, their article reports the findings using a porcine experimental preparation using cardiopulmonary bypass with a 45-minute period of selective bi-carotid perfusion at moderate hypothermia (25°C) and randomization to either alpha-stat or pH-stat blood gas management. Measured end points included a variety of biochemical indices, as well as observations of the status of brain microvasculature using a cranial window and intravital microscopy to assess the size at various points in time of arterial and venous cerebrocortical microvessels as well as the nature of leukocyte endothelial interactions. The important observations included higher concentration of brain lactate at various time points in the alpha-stat group without elevation of brain glutamate in either group. At no time . . . [Full Text of this Article]






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Copyright © 2007 by The Society of Thoracic Surgeons.