Comparison of Parameters for Detection of Splanchnic Hypoxia in Children Undergoing Cardiopulmonary Bypass With Pulsatile Versus Nonpulsatile Normothermia or Hypothermia During Congenital Heart Surgeries

Ali Riza Karaci, Ahmet Sasmazel, Numan Ali Aydemir, Turkay Saritas, Bugra Harmandar, Zeliha Tuncel, Akif Undar

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

The aim of this study is to evaluate gastric mucosal oxygenation together with whole-body oxygen changes in infants undergoing congenital heart surgery with cardiopulmonary bypass (CPB) procedure and the use of either pulsatile or nonpulsatile mode of perfusion with normothermia and pulsatile or nonpulsatile moderate hypothermia. Sixty infants undergoing congenital cardiac surgery were randomized into four groups as: nonpulsatile normothermia CPB (NNCPB, n=15), pulsatile normothermia CPB (PNCPB, n=15), nonpulsatile moderate hypothermia CPB (NHCPB, n=15), and pulsatile moderate hypothermia CPB (PHCPB, n=15) groups. In NNCPB and PNCPB groups, mild hypothermia was used (35°C), whereas in NHCPB and PHCPB groups, moderate hypothermia (28°C) was used. Gastric intramucosal pH (pHi), whole-body oxygen delivery (DO 2) and consumption (VO 2), and whole-body oxygen extraction fraction were measured at sequential time points intraoperatively and up to 2h postoperatively. The measurement of continuous tonometry data was collected at desired intervals. The values of DO 2, VO 2, and whole-body oxygen extraction fraction were not different between groups before CPB and during CPB, whereas the PNCPB group showed higher values of DO 2, VO 2, and whole-body oxygen extraction fraction compared to the other groups at the measurement levels of 20 and 60min after aortic cross clamp, end of CPB, and 2h after CPB (P<0.0001). Between groups, no difference was observed for pHi, lactate, and cardiac index values (P>0.05). This study shows that the use of normothermic pulsatile perfusion (35°C) provides better gastric mucosal oxygenation as compared to other perfusion strategies in neonates and infants undergoing congenital heart surgery with CPB procedures.

Original languageEnglish (US)
Pages (from-to)1010-1017
Number of pages8
JournalArtificial organs
Volume35
Issue number11
DOIs
StatePublished - Nov 1 2011

Fingerprint

Hypothermia
Viscera
Cardiopulmonary Bypass
Surgery
Thoracic Surgery
Oxygen
Oxygenation
Stomach
Clamping devices
Perfusion
Hypoxia
Pulsatile Flow
Manometry

All Science Journal Classification (ASJC) codes

  • Bioengineering
  • Medicine (miscellaneous)
  • Biomaterials
  • Biomedical Engineering

Cite this

Karaci, Ali Riza ; Sasmazel, Ahmet ; Aydemir, Numan Ali ; Saritas, Turkay ; Harmandar, Bugra ; Tuncel, Zeliha ; Undar, Akif. / Comparison of Parameters for Detection of Splanchnic Hypoxia in Children Undergoing Cardiopulmonary Bypass With Pulsatile Versus Nonpulsatile Normothermia or Hypothermia During Congenital Heart Surgeries. In: Artificial organs. 2011 ; Vol. 35, No. 11. pp. 1010-1017.
@article{56d6d909f27d42c7bde236bb5d467047,
title = "Comparison of Parameters for Detection of Splanchnic Hypoxia in Children Undergoing Cardiopulmonary Bypass With Pulsatile Versus Nonpulsatile Normothermia or Hypothermia During Congenital Heart Surgeries",
abstract = "The aim of this study is to evaluate gastric mucosal oxygenation together with whole-body oxygen changes in infants undergoing congenital heart surgery with cardiopulmonary bypass (CPB) procedure and the use of either pulsatile or nonpulsatile mode of perfusion with normothermia and pulsatile or nonpulsatile moderate hypothermia. Sixty infants undergoing congenital cardiac surgery were randomized into four groups as: nonpulsatile normothermia CPB (NNCPB, n=15), pulsatile normothermia CPB (PNCPB, n=15), nonpulsatile moderate hypothermia CPB (NHCPB, n=15), and pulsatile moderate hypothermia CPB (PHCPB, n=15) groups. In NNCPB and PNCPB groups, mild hypothermia was used (35°C), whereas in NHCPB and PHCPB groups, moderate hypothermia (28°C) was used. Gastric intramucosal pH (pHi), whole-body oxygen delivery (DO 2) and consumption (VO 2), and whole-body oxygen extraction fraction were measured at sequential time points intraoperatively and up to 2h postoperatively. The measurement of continuous tonometry data was collected at desired intervals. The values of DO 2, VO 2, and whole-body oxygen extraction fraction were not different between groups before CPB and during CPB, whereas the PNCPB group showed higher values of DO 2, VO 2, and whole-body oxygen extraction fraction compared to the other groups at the measurement levels of 20 and 60min after aortic cross clamp, end of CPB, and 2h after CPB (P<0.0001). Between groups, no difference was observed for pHi, lactate, and cardiac index values (P>0.05). This study shows that the use of normothermic pulsatile perfusion (35°C) provides better gastric mucosal oxygenation as compared to other perfusion strategies in neonates and infants undergoing congenital heart surgery with CPB procedures.",
author = "Karaci, {Ali Riza} and Ahmet Sasmazel and Aydemir, {Numan Ali} and Turkay Saritas and Bugra Harmandar and Zeliha Tuncel and Akif Undar",
year = "2011",
month = "11",
day = "1",
doi = "10.1111/j.1525-1594.2011.01378.x",
language = "English (US)",
volume = "35",
pages = "1010--1017",
journal = "Artificial Organs",
issn = "0160-564X",
publisher = "Wiley-Blackwell",
number = "11",

}

Comparison of Parameters for Detection of Splanchnic Hypoxia in Children Undergoing Cardiopulmonary Bypass With Pulsatile Versus Nonpulsatile Normothermia or Hypothermia During Congenital Heart Surgeries. / Karaci, Ali Riza; Sasmazel, Ahmet; Aydemir, Numan Ali; Saritas, Turkay; Harmandar, Bugra; Tuncel, Zeliha; Undar, Akif.

In: Artificial organs, Vol. 35, No. 11, 01.11.2011, p. 1010-1017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of Parameters for Detection of Splanchnic Hypoxia in Children Undergoing Cardiopulmonary Bypass With Pulsatile Versus Nonpulsatile Normothermia or Hypothermia During Congenital Heart Surgeries

AU - Karaci, Ali Riza

AU - Sasmazel, Ahmet

AU - Aydemir, Numan Ali

AU - Saritas, Turkay

AU - Harmandar, Bugra

AU - Tuncel, Zeliha

AU - Undar, Akif

PY - 2011/11/1

Y1 - 2011/11/1

N2 - The aim of this study is to evaluate gastric mucosal oxygenation together with whole-body oxygen changes in infants undergoing congenital heart surgery with cardiopulmonary bypass (CPB) procedure and the use of either pulsatile or nonpulsatile mode of perfusion with normothermia and pulsatile or nonpulsatile moderate hypothermia. Sixty infants undergoing congenital cardiac surgery were randomized into four groups as: nonpulsatile normothermia CPB (NNCPB, n=15), pulsatile normothermia CPB (PNCPB, n=15), nonpulsatile moderate hypothermia CPB (NHCPB, n=15), and pulsatile moderate hypothermia CPB (PHCPB, n=15) groups. In NNCPB and PNCPB groups, mild hypothermia was used (35°C), whereas in NHCPB and PHCPB groups, moderate hypothermia (28°C) was used. Gastric intramucosal pH (pHi), whole-body oxygen delivery (DO 2) and consumption (VO 2), and whole-body oxygen extraction fraction were measured at sequential time points intraoperatively and up to 2h postoperatively. The measurement of continuous tonometry data was collected at desired intervals. The values of DO 2, VO 2, and whole-body oxygen extraction fraction were not different between groups before CPB and during CPB, whereas the PNCPB group showed higher values of DO 2, VO 2, and whole-body oxygen extraction fraction compared to the other groups at the measurement levels of 20 and 60min after aortic cross clamp, end of CPB, and 2h after CPB (P<0.0001). Between groups, no difference was observed for pHi, lactate, and cardiac index values (P>0.05). This study shows that the use of normothermic pulsatile perfusion (35°C) provides better gastric mucosal oxygenation as compared to other perfusion strategies in neonates and infants undergoing congenital heart surgery with CPB procedures.

AB - The aim of this study is to evaluate gastric mucosal oxygenation together with whole-body oxygen changes in infants undergoing congenital heart surgery with cardiopulmonary bypass (CPB) procedure and the use of either pulsatile or nonpulsatile mode of perfusion with normothermia and pulsatile or nonpulsatile moderate hypothermia. Sixty infants undergoing congenital cardiac surgery were randomized into four groups as: nonpulsatile normothermia CPB (NNCPB, n=15), pulsatile normothermia CPB (PNCPB, n=15), nonpulsatile moderate hypothermia CPB (NHCPB, n=15), and pulsatile moderate hypothermia CPB (PHCPB, n=15) groups. In NNCPB and PNCPB groups, mild hypothermia was used (35°C), whereas in NHCPB and PHCPB groups, moderate hypothermia (28°C) was used. Gastric intramucosal pH (pHi), whole-body oxygen delivery (DO 2) and consumption (VO 2), and whole-body oxygen extraction fraction were measured at sequential time points intraoperatively and up to 2h postoperatively. The measurement of continuous tonometry data was collected at desired intervals. The values of DO 2, VO 2, and whole-body oxygen extraction fraction were not different between groups before CPB and during CPB, whereas the PNCPB group showed higher values of DO 2, VO 2, and whole-body oxygen extraction fraction compared to the other groups at the measurement levels of 20 and 60min after aortic cross clamp, end of CPB, and 2h after CPB (P<0.0001). Between groups, no difference was observed for pHi, lactate, and cardiac index values (P>0.05). This study shows that the use of normothermic pulsatile perfusion (35°C) provides better gastric mucosal oxygenation as compared to other perfusion strategies in neonates and infants undergoing congenital heart surgery with CPB procedures.

UR - http://www.scopus.com/inward/record.url?scp=81855192795&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=81855192795&partnerID=8YFLogxK

U2 - 10.1111/j.1525-1594.2011.01378.x

DO - 10.1111/j.1525-1594.2011.01378.x

M3 - Article

C2 - 22097978

AN - SCOPUS:81855192795

VL - 35

SP - 1010

EP - 1017

JO - Artificial Organs

JF - Artificial Organs

SN - 0160-564X

IS - 11

ER -