Abstract
Cardiopulmonary bypass (CPB) is a technique used to maintain adequate perfusion when the heart has been stopped. The technique is often utilized in coronary artery bypass graft (CABG) surgery where patients are often cooled in order to slow metabolism and reduce oxygen demand. In this study, measurements of the oxygen delivery and consumption during surgery were made from 12 patients to investigate the extent of hypothermic protection. During hypothermia, oxygen consumption was significantly reduced by an average of 43%, P < 0.003. During short intentional periods of reduced flow, and hence oxygen delivery, an oxygen debt was accrued which caused a period of increased oxygen consumption on resumption of full flow. During hypothermic CPB this oxygen repayment was 101 ± 8% and in normothermia was 78 ± 6% of the accrued debt.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kirklin JW, Barrat-Boyes BG (1993) Hypothermia, circulatory arrest and cardiopulmonary bypass. In: Kirklin JW, Barrat-Boyes BG (eds) Cardiac surgery. Livingstone, New York, pp 61–128
Fox LS, Blackstone EH, Kirklin JW et al (1984) Relationship of brain blood flow and oxygen consumption to perfusion flow rate during profoundly hypothermic cardiopulmonary bypass. An experimental study. J Thorac Cardiovasc Surg 87:658–664
Slater JM, Orszulak TA, Cook DJ (2001) Distribution and hierarchy of regional blood flow during hypothermic cardiopulmonary bypass. Ann Thorac Surg 72:542–547
Newman MF, Kirchner JL, Phillips-Bute B et al (2001) Longitudinal assessment of neurocognitive function after coronary-artery bypass surgery. N Engl J Med 344:395–402
A. Crerar-Gilbert, H. Bishop, J.A. Pickett et al (2001) Continuous arteriovenous oximetry as a measure of perfusion during hypothermic cardiopulmonary bypass. Br J Anaesth 87: 660P
Croughwell ND, Smith LR, Quill T (1992) The effect of temperature on cerebral metabolism and blood flow in adults during cardiopulmonary bypass. J Thorac Cardiovasc Surg 103:549–554
McCullough JN, Zhang N, Reich DL et al (1999) Cerebral metabolic suppression during hypothermic circulatory arrest in Humans. Ann Thorac Surg 67:1895–1899
Shoemaker WC, Appel PL, Kram HB (1992) Role of oxygen debt in the development of organ failure sepsis, and death in high-risk surgical patients. Chest 102:208–215
Cook DJ, Oliver WC, Orszulak TA et al (1995) Cardiopulmonary bypass temperature, hematocrit, and cerebral oxygen delivery in humans. Ann Thorac Surg 60:1671–1677
Mortillaro NA, Granger HJ (1977) Reactive hyperemia and oxygen extraction in the feline small intestine. Circ Res 41:859–864
Fahey JT, Lister G et al (1989) Response to low cardiac output: developmental differences in metabolism during oxygen deficit and recovery in lambs. Pediatr Res 26:180–187
Acknowledgments
J.A. is funded by the NHS London clinical scientist training scheme.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2012 Springer Science+Business Media, LLC
About this paper
Cite this paper
Ashmore, J., Pickett, J., Alder, J., Marks, R., Thorniley, M. (2012). Whole Body Oxygen Delivery and Consumption During Cardiopulmonary Bypass Surgery. In: Wolf, M., et al. Oxygen Transport to Tissue XXXIII. Advances in Experimental Medicine and Biology, vol 737. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1566-4_33
Download citation
DOI: https://doi.org/10.1007/978-1-4614-1566-4_33
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-1565-7
Online ISBN: 978-1-4614-1566-4
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)