体外循環ならびに表面冷却超低体温法および潅流加温法を用いた開心術の酸塩基平衡およびエネルギ-代謝の比較について
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概要
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Acid-base and energy metabolism associated with extracorporeal circulation and surface cooling ad perfusion rewarming for open heart surgery was discussed.<BR>Sixty five patients operated upon for correction of a serious cardic anomary were studied in order to evaluate changes that occured during, post cardiac bypass and post operation.<BR>Acid-base occured in under 3 years, 3-15 years cases showed respiratory alkalosis during to 90 minutes post cardiac bypass, post operation changed into slight metabolic alkalosis, over 15 years showed slight metabolic acidosis, post perfusion changed into metabolic alkalosis, in extracorporeal circulation. Deep hypothermia group showed metabolic acidosis during low temperatur but post operation changed into respiratory alkalosis and metabolic acidosis.<BR>Blood sugar increased by the cardiac bypass, however under 3 years, years 3-15 cases were greater over 15 years case, these changes recovered to normal with in 12 hours, in extracorporeal circuration. Deep hypothermia group increased out of surface cooling, and the high level lasted 5 hours after operation.<BR>Insulin level could not be secretively suppressied however over 15 years case were recognized more than other cases, in extracorporeal circulation. Deep hypothermia group showed monotoneous for 60 minutes post operatively.<BR>NEFA increased by the cardiac bypass, and which is reasons something to do with insulin secretion, in extracorpoleal circulation. Deep hypothermia group showed high level from surface cooling to perfusion rewarming.
- 学校法人 昭和大学・昭和医学会の論文