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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, howeve...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Termedia Publishing House
2016
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5420618/ https://www.ncbi.nlm.nih.gov/pubmed/28507572 http://dx.doi.org/10.5114/aoms.2016.58144 |
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author | Teloh, Johanna Katharina Dohle, Daniel-Sebastian Sönmez, Serhat Tsagakis, Konstantinos Verhaegh, Rabea Petersen, Miriam Jakob, Heinz de Groot, Herbert |
author_facet | Teloh, Johanna Katharina Dohle, Daniel-Sebastian Sönmez, Serhat Tsagakis, Konstantinos Verhaegh, Rabea Petersen, Miriam Jakob, Heinz de Groot, Herbert |
author_sort | Teloh, Johanna Katharina |
collection | PubMed |
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 (p < 0.0001) and –3.3 mEq/l (p < 0.0001), 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. |
format | Online Article Text |
id | pubmed-5420618 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-54206182017-05-15 Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting Teloh, Johanna Katharina Dohle, Daniel-Sebastian Sönmez, Serhat Tsagakis, Konstantinos Verhaegh, Rabea Petersen, Miriam Jakob, Heinz de Groot, Herbert Arch Med Sci Clinical Research 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 (p < 0.0001) and –3.3 mEq/l (p < 0.0001), 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. Termedia Publishing House 2016-04-07 2017-04-01 /pmc/articles/PMC5420618/ /pubmed/28507572 http://dx.doi.org/10.5114/aoms.2016.58144 Text en Copyright: © 2016 Termedia & Banach http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Clinical Research Teloh, Johanna Katharina Dohle, Daniel-Sebastian Sönmez, Serhat Tsagakis, Konstantinos Verhaegh, Rabea Petersen, Miriam Jakob, Heinz de Groot, Herbert Transient dilutional acidosis but no lactic acidosis upon cardiopulmonary bypass in patients undergoing coronary artery bypass grafting |
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 | Clinical Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5420618/ https://www.ncbi.nlm.nih.gov/pubmed/28507572 http://dx.doi.org/10.5114/aoms.2016.58144 |
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