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KMID : 0381219830150030158
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Journal of RIMSK
1983 Volume.15 No. 3 p.158 ~ p.166
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The Change of Blood Gas and Lactic Acid During Open Heart Surgery
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Abstract
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Open heart surgery developed universally. This study was carried out to examine the biochemical changes during open heart surgery in the 13 pediartic patients: nine patients with noncyanotic VSD, four with cyanotic TOF.
Arterial blood gas analysis and blood lactic acid level were measured before the anesthesia, and 15 and 60 minutes after the extracorporeal circulation in hypothermia of 28--30°C.
1) Before the anesthesia, mean Pa02 was 80±9 mmHg in the noncyanotic patients and 37±6 mmHg in the cyanotic patients. However, 15 minutes after extracorporeal circulation, Pa02 levels were maintained at 230±53 mmHg in the noncyanotic patients and 248±64 mmHg in the cyanotic patients. After 60 minutes, Pa02 levels were reduced to 154±65 mmHg and 191
±97 mmHg, respectively.
2) 02 content before the anesthesia was 16. 1 ml/100 ml in the noncyanotic patients and 20. 1 ml/100 ml in the cyanotic patients.
The cyanotic patients showed higher 02 content than non cyanotic patients during the extracorporeal circulation; 14. 8 ml/100 ml VS 11.9 ml/100 ml after 15 minutes, 14. 5 ml/100 ml vs 11.3 ml/100 ml after 60 minutes. Ca-VO2 levels were about the same in two groups during the extracorporeal circulation. 2.77 ml/100ml in non cyanotic and 2.86 ml/100 ml in cyanotic patients.
3) PaCO2 was reduced in both groups from 35-40 mmHg before the anesthesia to 25--30 mmHg during the extracorporeal circulation.
4) pH was shifted in both groups from acidosis(pH 7.33-pH 7.34) before the anesthesia to alkalosis(pH 7.45-pH 7.54) during the extracorporeal circulation.
5) Buffer base was lower in the cyanotic patients than in the noncyanotic patients before the anethesia, 20. 2 mmol/1 vs 24. 7 mmol/1, and it did not change significantly during the extracorporeal circulation.
6) Lactic acid level in the noncyanotic patients was lower than in the cyanotic patients before the anethesia, 11. 9 mg/100 ml vs 50.7 mg/100 ml. During the extracorpororeal circulation, it was increased to 49. 6 mg/100 ml in the noncyanotic patients and 81.2 mg/100 ml in the cyanotic patients and these levels were maintained throughout the extracorporeal circulation.
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