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Clinical and Metabolic Effects of Cardiopulmonary Bypass : 체외순환의 임상 및 대사효과

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서울대학교 의과대학
Seoul J Med, Vol.17 No.3, pp. 179-199
The clinical and metabolic effects of cardiopulmonary
bypass were stduied with fifty-three
patients who underwent open heart surgery by
evaluating serial laboratory examinations and
clinical results. Mild anemia was a finding after
extracorporeal circulations along with the thrombocytopenia
followed by a platelet rebound.
Hypokalemia was a characteristic of cardiopulmonary
bypass being evidenced by low serum
potassium levels during and after extracorporeal
circulation and by the increased urinary excretion
of potassium which exceeded the one of
sodium in the early postoperative days. The
changes of total calcium and magnesium during
cardiopulmonary bypass were dependent upon their levels in the prime of oxygenator. Of
serum enzymes the significant increases of
SGOT and SLDH after cardiopulmonary bypass
suggested various tissue injuries including
thoracotomy, cardiotomy, sublethal damage to,
red blood cells and hemolysis from the presence
of prosthetic cardiac valves. The changes of
SGPT were mild and delayed. Marked respiratory
alkalosis accompanied with mild degrees
of metabolic acidosis were the characteristic
pattern during and early after cardiopulmonary
The most common complications were the
infection of sternotomy wounds. Although these
were superficial in nature, they prolonged the
patient's hospital stays. Disturbances of cardiac
rhythms or conduction mechanisms were the
next commonly seen complications and they
were fatal when ventricular arrhythmias were
intractable and surgical block was not treated
with pacemaker implantation. There were 10
deaths, or 18.9 percent, while patients were
in hospital. The hospital mortality rates among
groups were 11. 2 percent (l of 9) after repairs
of atrial septal septal defect, none after closure
of ventricular septal defect, 26.3 percent (6 of
19) after total correction of tetralogy of Fallot
and interventricular correction of double outlet
right ventricle, and 28.6 percent (4 of 14)
after valve replacement.
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