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• W2091254659 abstract "Selective cerebral perfusion (SCP) and open distal anastomosis (OD) with hypothermia has been utilized as a popular modality for circulatory assistance in aortic arch surgery. Although SCP has become accepted for cerebral protection, the influence of OD, accompanying with body circulatory arrest, on lower body ischemia has not been known enough. Therefore, we evaluated the body ischemia during OD using gastric intramucosal pH (pHim) meter (tonometer) and its relation to postoperative organ functions. Method: In 5 patients (pts) (65–78yrs, mean 71 yrs: group OD) who underwent arch replacement using SCP and OD with moderate hypothermia (25°C) from March to August 1999, pHim was measured before(pre-OD), during(end of OD) and 60 minutes after OD(post -OD) during cardiopulmonary bypass. Six pts (65–75 yrs, mean 69 yrs) who received coronary artery bypass at the same period were served as control (group C) Results: The pHim was significantly decreased at end of OD (7.35-0.03 pre-OD vs 7.23±0.03 at end of OD, p < 0.05) and recovered completely at post-OD (7.32 ± 0.02). The pHim at end of OD was not correlated with the duration of OD (30–47 min., mean 38 min.). Renal function on the 1st postoperative day was significantly (p < 0.05) reduced in group OD (BUN: 21±4.1 mg/dl, CCr 82±6.0 ml/min) than in group C (BUN: 16±3.4mg/dl, CCr: 118±ml/min) although there were no differences in preoperative values between two groups. PHim at OD was significantly correlated to the 1st PO BUN (r=0.97, p < 0.01) and CCr(r=0.85, p < 0.05). One patient developed paraplegia postoperatively and his pHim at OD was severely decreased (pHim=7.11). Conclusion: These results suggest that intraoperative monitoring of pHim is beneficial for the evaluation of body and spinal ischemia during OD for arch replacement and may contribute to improve the circulatory technique in aortic surgery." @default.
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• W2091254659 date "2000-03-01" @default.
• W2091254659 modified "2023-10-16" @default.
• W2091254659 title "EVALUATION OF BODY ISCHEMIA BY GASTRIC INTRAMUCOSAL PH DURING SELECTIVE CEREBRAL PERFUSION AND OPEN DISTAL ANASTOMOSIS IN AORTIC ARCH REPAIR" @default.
• W2091254659 doi "https://doi.org/10.1097/00002480-200003000-00130" @default.
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