Preserved gastric tonometric variables in cardiac surgical patients administered intravenous perflubron emulsion.

Abstract

UNLABELLED:

Low gastric intramucosal pH (pHi) and an increased gastric-arterial PCO2 difference (CO2 gap) are markers of tissue hypoperfusion. Perfluorocarbons (PFCs) have a large oxygen-carrying capacity and release oxygen when encountering low tissue oxygen tension. Nine cardiac surgical patients instrumented for gastric tonometry were enrolled as part of a multicenter, randomized, single-blinded study of a PFC emulsion (perflubron emulsion [Oxygent]). Patients were randomized to receive PFC (n = 4) or placebo (n = 5) after intraoperative autologous blood harvesting by acute normovolemic hemodilution. At baseline there were no intergroup differences in tonometric-, hemodynamic-, or oxygen delivery-derived variables, e.g., Control group (pHi, 7.37 +/- 0.06; CO2 gap, 6.4 +/- 1.3 mm Hg) versus PFC group (pHi, 7.38 +/- 0.06; CO2 gap, 6.7 +/- 1.5 mm Hg). After acute normovolemic hemodilution, pHi was significantly lower (P < 0.01) in the Control group (7.22 +/- 0.25) than in the PFC group (7.44 +/- 0.25), and CO2 gap was significantly higher (P < 0.001) in the Control group (23.4 +/- 5.1 mm Hg) than in the PFC group (1.8 +/- 0.8 mm Hg). These differences in tonometric variables persisted during surgery. The PFC group showed a significantly (P < 0.007) shorter time to first bowel movement postoperatively (2.0 +/- 0.8 vs 5.4 +/- 1.6 days). Time to consumption of solid food was also shorter in the PFC group and almost achieved statistical significance (P = 0.056).

IMPLICATIONS:

This study suggests that the administration of perflubron emulsion prevents gastrointestinal tract ischemia in cardiac surgical patients and may preserve postoperative gastrointestinal tract function.

• Authors: Robert J Frumento, Linda Mongero, Yoshifumi Naka, Elliott Bennett-Guerrero
• Journal: Anesthesia and analgesia (Anesth Analg) Vol. 94 Issue 4 Pg. 809-14, table of contents (Apr 2002) ISSN: 0003-2999 [Print] United States
• PMID: 11916777 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article, Multicenter Study, Randomized Controlled Trial)

Chemical References

• Emulsions
• Fluorocarbons
• Hemoglobins
• Hydrocarbons, Brominated
• Carbon Dioxide
• perflubron
• Oxygen

Topics

• Aged
• Blood Transfusion, Autologous
• Carbon Dioxide (blood, metabolism)
• Cardiopulmonary Bypass
• Coronary Artery Bypass
• Emulsions
• Fluorocarbons (administration & dosage)
• Gastric Mucosa (blood supply, metabolism)
• Hemodilution
• Hemoglobins (analysis)
• Humans
• Hydrocarbons, Brominated
• Hydrogen-Ion Concentration
• Infusions, Intravenous
• Middle Aged
• Oxygen (blood)
• Oxygen Consumption
• Partial Pressure
• Single-Blind Method