Relationship between Arterial Keton Body Ratio(AKBR) and Hepatic Blood Flow after Extracorporeal Circulation.

Takeuchi, Koh; Fukui, Kozo; Koyama, K.; Sawada, Mitsuhiro; Takahashi, Shouichi; Yamada, Yosuke; Ono, Yūichi; Iwabuchi, Satoshi; Shuto, K; Suzuki, Sohei; Koie, H

doi:10.4326/jjcvs.21.141

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“…In respect of AKBR, a parameter that shows the condition of oxidation–reduction in liver mitochondria (25), there was no difference between the two groups in this study. Takeuchi et al reported that AKBR correlated with the blood flow in hepatic tissues during CPB, and that pulsatile CPB was better than nonpulsatile CPB (26). We postulate the following to explain why the present study did not show this difference: Under this CPB condition, the portal vein was not influenced by the pulse pressure, and full blood flow was maintained with a normal ratio because the portal vein belongs to the low pressure system.…”

Section: Discussionmentioning

confidence: 99%

Effects of Pulsatile CPB on Interleukin‐8 and Endothelin‐1 Levels

Sezai¹,

Shiono²,

Nakata³

et al. 2005

Artificial Organs

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Studies on pulsatile and nonpulsatile perfusion have long been performed. However, investigators have not reached a conclusion on which is more effective. In the present study, pulsatile cardiopulmonary bypass (CPB) was investigated in terms of the effects on cytokines, endothelin, catecholamine, and pulmonary and renal functions. Twenty-four patients who underwent coronary artery bypass grafting were divided into a pulsatile CPB group and a nonpulsatile CPB group. Parameters examined were hemodynamics, interleukin-8 (IL-8), endothelin-1 (ET-1), epinephrine, norepinephrine, lactate, arterial ketone body ratio, urine volume, blood urea nitrogen, creatinine, renin activity, angiotensin-II, lactate dehydrogenase, plasma-free hemoglobin, tracheal intubation time, and respiratory index. The IL-8 at 0.5, 3, and 6 h after CPB, and ET-1 at 3, 6, 9, and 18 h after CPB were significantly lower in the pulsatile group. Both epinephrine and norepinephrine were significantly lower in the pulsatile group. The respiratory index was significantly higher in the pulsatile group. In the present study, inhibitory effects on cytokine activity, edema in pulmonary alveoli, and endothelial damage were shown in addition to the favorable effects on catecholamine level, renal function, and peripheral circulation that have already been documented.

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Section: Discussionmentioning

confidence: 99%