Journal
ANESTHESIA AND ANALGESIA
Volume 108, Issue 5, Pages 1389-1393Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1213/ane.0b013e318187c39d
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- Cardiovascular Anesthesia Research Fund of the Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas
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In a prospective, randomized study of cardiac surgical patients at risk for impaired cerebral blood flow autoregulation, we compared alpha-stat and pH-stat blood gas management. The 40 patients enrolled had age >70 yr, diabetes, prior stroke, or uncontrolled hypertension. During hypothermia and early rewarming, jugular oxygen tensions were significantly lower in a-stat patients (n = 12) than pH-stat patients (n = 19; P < 0.05). During rewarming, jugular venous desaturation (i.e., SjvO(2) <50%) occurred in 6 of 12 a-stat patients, but no pH-stat patients (P = 0.0006). Patients at risk for poor cerebral autoregulation have higher oxygen tensions and saturations if pH-stat blood gas management is used during cardiopulmonary bypass.
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