British Journal of Anaesthesia, Vol 82, Issue 5 738-745, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
M. Haisjackl, R. Germann, W. Hasibeder, B. Schwarz, N. Salak, W. Pajk, J. Bonatti, W. Nussbaumer, G. Klima, W. Kox and N. Mutz
Cardiopulmonary bypass (CPB) has been associated with intestinal tissue
hypoxia, but direct measurements of mucosal oxygenation have not been
performed. In anaesthetized pigs, jejunal mucosal oxygen tension and
microvascular haemoglobin oxygen saturation were measured by a Clark- type
electrode and tissue reflectance spectrophotometry. In pigs, normothermic
CPB with systemic oxygen transport equivalent to baseline values was
performed. In control animals, mucosal oxygen tension and mucosal
haemoglobin oxygen saturation were mean 5.01 (SD 1.08) kPa and 38.0 (2.3)%,
respectively. CPB was associated with a decrease in mucosal oxygen tension
to 2.26 (1.21) kPa, decrease in mucosal microvascular haemoglobin oxygen
saturation to 26.0 (3.9)% and appearance of oscillations in mucosal
microvascular haemoglobin oxygen saturation. With CPB, arterial lactate
concentrations increased from 1.77 (1.37) to 3.52 (1.58) mmol litre-1, but
transvisceral lactate and splanchnic venous-arterial carbon dioxide tension
gradients remained unchanged. Our results support the concept that CPB is
associated with diminished oxygenation of intestinal mucosa that is
probably caused by regional redistribution.
LABORATORY INVESTIGATIONS
Mucosal tissue oxygenation of the porcine jejunum during normothermic cardiopulmonary bypass
Department of Anaesthesia and Intensive Care and Department of Cardiac Surgery, University Hospital Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria; Department of Anaesthesia and Intensive Care, Humboldt University Hospital Charite, Schumannstrasse 20-21, A-10117 Berlin, Germany
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