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Jugular venous oxygenation during hypothermic cardiopulmonary bypass in patients at risk for abnormal cerebral autoregulation: influence of alpha-Stat versus pH-stat blood gas management.

Authors
  • Hoover, Lance R
  • Dinavahi, Radhika
  • Cheng, Wei-Ping
  • Cooper, John R Jr
  • Marino, Maria Rosa
  • Spata, Tyler C
  • Daniels, Gaile L
  • Vaughn, William K
  • Nussmeier, Nancy A
Type
Published Article
Journal
Anesthesia & Analgesia
Publisher
Ovid Technologies (Wolters Kluwer) - Anesthesia & Analgesia
Publication Date
May 01, 2009
Volume
108
Issue
5
Pages
1389–1393
Identifiers
DOI: 10.1213/ane.0b013e318187c39d
PMID: 19372312
Source
Medline
License
Unknown

Abstract

In a prospective, randomized study of cardiac surgical patients at risk for impaired cerebral blood flow autoregulation, we compared alpha-stat and pH-stat blood gas management. The 40 patients enrolled had age >70 yr, diabetes, prior stroke, or uncontrolled hypertension. During hypothermia and early rewarming, jugular oxygen tensions were significantly lower in alpha-stat patients (n = 12) than pH-stat patients (n = 19; P < 0.05). During rewarming, jugular venous desaturation (i.e., SjvO(2) <50%) occurred in 6 of 12 alpha-stat patients, but no pH-stat patients (P = 0.0006). Patients at risk for poor cerebral autoregulation have higher oxygen tensions and saturations if pH-stat blood gas management is used during cardiopulmonary bypass.

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