Optimization of oxygen transport in operations with cardiopulmonary bypass
Aim. Comparative analysis of central hemodynamics and oxygen transport during cardiopulmonary bypass with non-pulsed and pulsed flow. Material and methods. The study involved 135 patients operated on for coronary artery disease with cardiopulmonary bypass. Results. All patients found the development of hypertensive reactions cardio-vascular system with an increase in cardiac output and impaired oxygen transport before and after the induction of anesthesia. Conduct of cardiopulmonary bypass pulsed to stabilize the venous saturation (SvO 2), oxygen tension (pvO 2) venous blood and oxygen extraction ratio (ErO 2). SvO 2 patients of the study group was 75,6 ± 2,1%, in patients of the control group - 82,5 ± 0,9%, pvO 2 42,3 ± 0,9 vs 53,9 ± 0,9 mm Hg. ERO 2 in the study group corresponds to the physiological range (24,6 ± 0,9%), while in the control group - reduced to 18,7 ± 0,3%, which indicates the formation of arterial-venous shunt, violation of return oxygen to the tissues and the formation of oxygen debt. Conclusion. It is shown that the use of pulsatile flow with high space velocity allows for the preservation of central hemodynamics, oxygen transport and consumption within the physiological range, avoid significant metabolic abnormalities in myocardial revascularization with cardiopulmonary bypass.