ACD혈액 희석 관류의 산 염기평형

Abstract

Acid-base balance of cardiopulmonary bypass cases utilizing ACD blood and hemodilution technique with helix reservoir and Rygg-Kyvsgaard bag oxygenators in sixteen patients was studied. The acid•base balanc of prime blood was one of the great concern in the course of the post-perfusion period, and it suggested that the adequate correction of metabolic acidosis of priming blood should be done before heart-lung bypass. It was also indicated that the inadequate tissue perfusion may be the cause of inescapable metabolic acidosis after extracorporeal circulation and stressed the neccessity of hemodynamic considerations altogether. The four cases of mortality were due to ventricular fibrilation which seemed to be caused mainly by metabolic acidosis. The average values observed immediately after perfusion were as follows: pH 7.344 (7.214-7.474), pC02 34. 6 07. 5-57. 7)mm. Hg. , standard bicarbonate 19. 305. 0-24. 0) mEq. /L., actual bicarbonate 18. 0 02. 2-23. 5)mEq. /L., total CO2 19. 002. 7-25. 2)mEq. / L., base excess -6. 1 (-12. 1-+1. 0) mEq. /L. and buffer base 41.8 (33.7-63. O)mEq./L.