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[Intramucosal intraoperative gastric pH (pHi) during cardiac surgery] surgery]
J Llagunes-Herrero1, J C Català-Bauset, P Marín-Pardo
1Servicio de Anestesiología y Reanimación, Hospital General Universitario, Valencia.
Objective:
To evaluate the monitoring of intramucosal pH (pHi) and standard pH (pHs) during heart surgery with extracorporeal circulation (ECC) and moderate hypothermia. The correlations of pHi and pHs and the postoperative APACHE III score after surgery were analyzed.
Patients And Methods:
Sixteen patients with cardiac output > 0.4 scheduled for coronary bypass surgery, or aortic or mitral valve replacement were studied. Arterial pH (pHa), pHi and pHs were measured and the difference between pHa and pHi was calculated before starting ECC (T0), during ECC and hypothermia (T1) and after termination of ECC (T2). The APACHE III score was recorded 18 h after surgery.
Results:
No significant differences between the pHi and pHs were observed in these patients. pHi was significantly higher during ECC with hypothermia (T1) than at baseline (T0). pHi and pHs were significantly correlated during the study period. There was no correlation between the APACHE III score in the immediate postoperative period and either pHi or pHs during surgery.
Conclusion:
Periods of splanchnic hypoxia (pHi < 7.32) during heart surgery with moderate hypothermia were not seen in patients with cardiac output > 0.4. pHs is a reliable measurement of pHi. There is no relation between APACHE III scores in the early postoperative period and pHi or pHs levels during surgery.