E0029627

metadata only access

Not Applicable (or Unknown)

ショウニ カイシンジュツゴ ノ シンキン タイシャ オヨビ ケッセイ コウソ ノ ヘンドウ ニカンスル ケンキュウ : カクシュ カイシンジュツ ホジョ シュダン ノ ヒカク ケントウ

Changes in myocardial metabolism and serum enzymes following open-heart surgery in children : Comparative study of various methods of myocardial protection

Japanese (日本語)

Medical journal of Kobe University

45(1)

67-90

1984-01

Study on changes in various parameters of myocardial metabolism and serum enzymes was carried out in 154 children who underwent open-heart surgery with cardiopulmonary bypass (CPB) to evaluate the various methods of myocardial protection. Patients were classified into 4 groups according to the methods of myocardial protection. Group I : electrical induced ventricular fibrillation ---34 cases. Group II : cold GIK cardioplegia with local cardiac cooling--- 78 cases. Group III : profound hypothermia with limitted CPB and cold crystalloid coronary perfusion---32 cases. Group IV : GIK cardioplegia combined with simple aortic cross-clamp ---10 cases. Argyle intravenous catheters were placed into the coronary sinus through the right atrial wall in 56 out of 154 children subjected to this study for sampling of coronary sinus blood. Following results were obtained. 1) Evaluation of the myocardial metabolism on the bases of lactate and oxygen extaction, excess lactate, and redox potential, indicated that the myocardial metabolism was kept in aerobic state throughout the postoperative course including the immediate postbypass period in group II with aortic cross-clamp less than 60 minutes. But in group I, III and group II with aortic cross-clamp over 60 minutes, the myocardial metabolism was found to be anaerobic in the immediate postbypass period and turned to aerobic one or 2 hours later. 2) Evaluation of the arterial -coronary sinus blood difference of various enzymes indicated that MB-CPK was the most reliable index to estimate the effectivenss of myocardial protection during cardiac surgery. 3) Enzymatic studies showed no statistically significant difference in the effectiveness of myocardial protection between group I, II and III, but the myocardial metabolic studies indicated that the myocardial protection was obtained most effectively in group II.

enzymatic study

紀要論文