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Splanchnic lactate production in cardiac surgery patients.

Authors
Type
Published Article
Journal
Critical Care Medicine
0090-3493
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Volume
21
Issue
2 Suppl
Identifiers
PMID: 8428503
Source
Medline

Abstract

The abdominal organs tolerate reductions in DO2 when they are cold (25 degrees C), since gastric intramucosal pH (a marker of inadequate DO2), and hepatic venous lactate/pyruvate ratios and oxygen saturation during the first half of cardiopulmonary bypass are normal. As surgery nears completion and core temperature is increased, tissue oxygen demands escalate. The presence of gastric mucosal acidosis, coupled with lactic acidemia and oxygen desaturation of hepatic venous blood, suggest that delivery of oxygen to the abdominal organs at the conclusion of cardiopulmonary bypass is insufficient to meet demand. A growing proportion of cardiac surgery patients are older and many have concomitant medical problems that can impair their recovery. Useful strategies are needed to reduce the occurrence of splanchnic ischemia in these and other high-risk populations if surgical outcome is to improve in the future.

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