Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting
Introduction : Dilutional acidosis may result from the introduction of a large fluid volume into the patients’ systemic circulation, resulting in a considerable dilution of endogenous bicarbonate in the presence of a constant carbon dioxide partial pressure. Its significance or even existence, howev...
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| Format: | Article |
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Termedia Publishing House
2016-04-01
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| Series: | Archives of Medical Science |
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| Online Access: | https://www.termedia.pl/Transient-dilutional-acidosis-but-no-lactic-acidosis-upon-cardiopulmonary-bypass-in-patients-undergoing-coronary-artery-bypass-grafting,19,27017,1,1.html |
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| author | Johanna Katharina Teloh Daniel-Sebastian Dohle Serhat Sönmez Konstantinos Tsagakis Rabea Verhaegh Miriam Petersen Heinz Jakob Herbert de Groot |
| author_facet | Johanna Katharina Teloh Daniel-Sebastian Dohle Serhat Sönmez Konstantinos Tsagakis Rabea Verhaegh Miriam Petersen Heinz Jakob Herbert de Groot |
| author_sort | Johanna Katharina Teloh |
| collection | DOAJ |
| description | Introduction : Dilutional acidosis may result from the introduction of a large fluid volume into the patients’ systemic circulation, resulting in a considerable dilution of endogenous bicarbonate in the presence of a constant carbon dioxide partial pressure. Its significance or even existence, however, has been strongly questioned. Blood gas samples of patients operated on with standard cardiopulmonary bypass (CPB) were analyzed in order to provide further evidence for the existence of dilutional acidosis.
Material and methods : Between 07/2014 and 10/2014, a total of 25 consecutive patients scheduled for elective isolated coronary artery bypass grafting with CPB were enrolled in this prospective observational study. Blood gas samples taken regularly after CPB initiation were analyzed for dilutional effects and acid-base changes.
Results : After CPB initiation, hemoglobin concentration dropped from an average initial value of 12.8 g/dl to 8.8 g/dl. Before the beginning of CPB, the mean value of the patients’ pH and base excess (BE) value averaged 7.41 and 0.5 mEq/l, respectively. After the onset of CPB, pH and BE values significantly dropped to a mean value of 7.33 and –3.3 mEq/l, respectively, within the first 20 min. In the following period during CPB they recovered to 7.38 and –0.5 mEq/l, respectively, on average. Patients did not show overt lactic acidosis.
Conclusions : The present data underline the general existence of dilutional acidosis, albeit very limited in its duration. In patients undergoing coronary artery bypass grafting it seems to be the only obvious disturbance in acid-base homeostasis during CPB. |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1734-1922 1896-9151 |
| language | English |
| last_indexed | 2024-12-17T07:32:47Z |
| publishDate | 2016-04-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Archives of Medical Science |
| spelling | doaj.art-d9317e80b93a41848882be9cc13cc27b2022-12-21T21:58:27ZengTermedia Publishing HouseArchives of Medical Science1734-19221896-91512016-04-0113358559010.5114/aoms.2016.5814427017Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass graftingJohanna Katharina TelohDaniel-Sebastian DohleSerhat SönmezKonstantinos TsagakisRabea VerhaeghMiriam PetersenHeinz JakobHerbert de GrootIntroduction : Dilutional acidosis may result from the introduction of a large fluid volume into the patients’ systemic circulation, resulting in a considerable dilution of endogenous bicarbonate in the presence of a constant carbon dioxide partial pressure. Its significance or even existence, however, has been strongly questioned. Blood gas samples of patients operated on with standard cardiopulmonary bypass (CPB) were analyzed in order to provide further evidence for the existence of dilutional acidosis. Material and methods : Between 07/2014 and 10/2014, a total of 25 consecutive patients scheduled for elective isolated coronary artery bypass grafting with CPB were enrolled in this prospective observational study. Blood gas samples taken regularly after CPB initiation were analyzed for dilutional effects and acid-base changes. Results : After CPB initiation, hemoglobin concentration dropped from an average initial value of 12.8 g/dl to 8.8 g/dl. Before the beginning of CPB, the mean value of the patients’ pH and base excess (BE) value averaged 7.41 and 0.5 mEq/l, respectively. After the onset of CPB, pH and BE values significantly dropped to a mean value of 7.33 and –3.3 mEq/l, respectively, within the first 20 min. In the following period during CPB they recovered to 7.38 and –0.5 mEq/l, respectively, on average. Patients did not show overt lactic acidosis. Conclusions : The present data underline the general existence of dilutional acidosis, albeit very limited in its duration. In patients undergoing coronary artery bypass grafting it seems to be the only obvious disturbance in acid-base homeostasis during CPB.https://www.termedia.pl/Transient-dilutional-acidosis-but-no-lactic-acidosis-upon-cardiopulmonary-bypass-in-patients-undergoing-coronary-artery-bypass-grafting,19,27017,1,1.htmlmetabolic acidosis priming solution cardioplegia cardioplegic solution |
| spellingShingle | Johanna Katharina Teloh Daniel-Sebastian Dohle Serhat Sönmez Konstantinos Tsagakis Rabea Verhaegh Miriam Petersen Heinz Jakob Herbert de Groot Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting Archives of Medical Science metabolic acidosis priming solution cardioplegia cardioplegic solution |
| title | Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting |
| title_full | Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting |
| title_fullStr | Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting |
| title_full_unstemmed | Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting |
| title_short | Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting |
| title_sort | transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting |
| topic | metabolic acidosis priming solution cardioplegia cardioplegic solution |
| url | https://www.termedia.pl/Transient-dilutional-acidosis-but-no-lactic-acidosis-upon-cardiopulmonary-bypass-in-patients-undergoing-coronary-artery-bypass-grafting,19,27017,1,1.html |
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