| Title | Preserved gastric tonometric variables in cardiac surgical patients administered intravenous perflubron emulsion. | | Author(s) | Frumento RJ, Mongero L, Naka Y, Bennett-Guerrero E | | Institution | Department of Anesthesiology, Columbia University College of Physicians & Surgeons, New York, New York 10032-3784, USA. rf356@columbia.edu | | Source | Anesth Analg 2002 Apr; 94(4):809-14, table of contents. | | MeSH | Aged
Blood Transfusion, Autologous
Carbon Dioxide
Cardiopulmonary Bypass
Coronary Artery Bypass
Emulsions
Fluorocarbons
Gastric Mucosa
Hemodilution
Hemoglobins
Humans
Hydrogen-Ion Concentration
Infusions, Intravenous
Middle Aged
Oxygen
Oxygen Consumption
Partial Pressure
Single-Blind Method
| | Abstract | Low gastric intramucosal pH (pHi) and an increased gastric-arterial PCO2 difference (CO2 gap) are markers of tissue hypoperfusion. Perfluorocarbons (PFCs) have a large oxygen-carrying capacity and release oxygen when encountering low tissue oxygen tension. Nine cardiac surgical patients instrumented for gastric tonometry were enrolled as part of a multicenter, randomized, single-blinded study of a PFC emulsion (perflubron emulsion [Oxygent]). Patients were randomized to receive PFC (n = 4) or placebo (n = 5) after intraoperative autologous blood harvesting by acute normovolemic hemodilution. At baseline there were no intergroup differences in tonometric-, hemodynamic-, or oxygen delivery-derived variables, e.g., Control group (pHi, 7.37 +/- 0.06; CO2 gap, 6.4 +/- 1.3 mm Hg) versus PFC group (pHi, 7.38 +/- 0.06; CO2 gap, 6.7 +/- 1.5 mm Hg). After acute normovolemic hemodilution, pHi was significantly lower (P < 0.01) in the Control group (7.22 +/- 0.25) than in the PFC group (7.44 +/- 0.25), and CO2 gap was significantly higher (P < 0.001) in the Control group (23.4 +/- 5.1 mm Hg) than in the PFC group (1.8 +/- 0.8 mm Hg). These differences in tonometric variables persisted during surgery. The PFC group showed a significantly (P < 0.007) shorter time to first bowel movement postoperatively (2.0 +/- 0.8 vs 5.4 +/- 1.6 days). Time to consumption of solid food was also shorter in the PFC group and almost achieved statistical significance (P = 0.056).
IMPLICATIONS: This study suggests that the administration of perflubron emulsion prevents gastrointestinal tract ischemia in cardiac surgical patients and may preserve postoperative gastrointestinal tract function. | | Language | eng | | Pub Type(s) | Clinical Trial
Clinical Trial, Phase II
Journal Article
Multicenter Study
Randomized Controlled Trial
| | PubMed ID | 11916777 |
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