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Hepatosplanchnic oxygenation is better preserved during mild hypothermic than during normothermic cardiopulmonary bypass

[L'oxygénation hépatosplanchnique est mieux préservée pendant la circulation extracorporelle sous légère hypothermie que sous normothermie]

Nobuhiro Okano, MD^*, Haruhiko Hiraoka, MD^*, Ryoichi Owada, MD^*, Nao Fujita, MD^*, Yuji Kadoi, MD, Shigeru Saito, MD, Fumio Goto, MD and Toshihiro Morita, MD^*

^* From the Department of Anesthesiology, Saitama Cardiovascular and Pulmonary Center, Saitama; and
the Department of Anesthesiology and Reanimatology, Gunma University, School of Medicine, Gunma, Japan.

Dr. Nobuhiro Okano, Department of Anesthesiology, Saitama Cardiovascular and Pulmonary Center, 1696 Itai Konan-machi Osato-gun, Saitama 360-0105, Japan. Phone: 81-48-536-9900; Fax: 81-48-536-9920; E-mail: richard{at}ka2.so-net.ne.jp

Purpose: To assess and compare the effects of normothermic and mild hypothermic cardiopulmonary bypass (CPB) on hepatosplanchnic oxygenation.

Methods: We studied 14 patients scheduled for elective coronary artery bypass graft surgery who underwent normothermic (>35°C; group I, n=7) or mild hypothermic (32°C; group II, n=7) CPB. After induction of anesthesia, a hepatic venous catheter was inserted into the right hepatic vein to monitor hepatic venous oxygen saturation (ShvO₂) and hepatosplanchnic blood flow by a constant infusion technique that uses indocyanine green.

Results: The ShvO₂ decreased from a baseline value in both groups during CPB and was significantly lower at ten minutes and 60 min after the onset of CPB in group I (39.5 ± 16.2% and 40.1 ± 9.8%, respectively) than in group II (61.1 ± 16.2% and 61.0 ± 17.9%, respectively; P <0.05). During CPB, the hepatosplanchnic oxygen extraction ratio was significantly higher in group I than in group II (44.0 ± 7.2% vs 28.7 ± 13.1%; P <0.05).

Conclusion: Hepatosplanchnic oxygenation was better preserved during mild hypothermic CPB than during normothermic CPB.

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