| Japanese |
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| Title | 体外循環後症例における消化管領域の循環動態の検討 |
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| Authors | 高橋徹*, 国元文生**, 小谷野哲也*, 石川進*, 大滝章男*, 長谷川豊*, 大木聡*, 坂田修治*, 村上淳*, 森下靖雄* |
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| Organization | *群馬大学医学部第2外科, **群馬大学医学部集中治療部 |
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| Journal | 循環制御 |
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| Volume | 19 |
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| Number | 3 |
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| Page | 387-391 |
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| Year/Month | 1998/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」体外循環後の消化管領域の循環動態を, 胃粘膜pH(pHi)と肝静脈血酸素飽和度(Shvo2)を通して検討した. 心臓手術症例にトノミ−タを胃内に挿入してpHiを, またカテーテルを肝静脈に挿入してShvo2を, ICU入室後に測定した. 「結果」心係数は4L/min/m2以上で, 体血管抵抗係数も正常位にあり, 末梢循環は良好に維持されていた. pHiはICU入室後に低く, その後有意に上昇した. Shvo2は60%前後を推移した. 「まとめ」体外循環後の消化管粘膜血流は, 心拍出量が維持されていても低く, これは24時間以内に改善した. Shvo2は有意な変化がなく, 胃粘膜とは別の循環制御が行われていることが示唆された. pHi測定および肝静脈血分析は, 消化管の循環動態を反映する指標になると思われた. |
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| Practice | 基礎医学・関連科学 |
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| English |
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| Title | Splanchnic Circulation after Cardiopulmonary Bypass |
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| Subtitle | |
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| Authors | Toru Takahashi*, Fumio Kunimoto**, Tetsuya Koyano*, Yutaka Hasegawa*, Susumu Ishikawa*, Akio Ohtaki*, Satoshi Oki*, Shuji Sakata*, Jun Murakami*, Yasuo Morishita* |
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| Authors(kana) | |
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| Organization | *Second Department of Surgery, **Intensive Care Unit, Gunma University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 19 |
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| Number | 3 |
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| Page | 387-391 |
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| Year/Month | 1998/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | To determine splanchnic circulation folloWing open-heart surgery, gastric intramucosal pH (pHi) and hepatic venous oxygen saturation (Shvo2) were measured in 35 patients with open-heart surgery. A hepatic venous catheter for blood sampling was placed into the right or middle hepatic vein under the fluoroscopic guidance. A gastric tonometer was advanced into the stomach after the admission to the ICU. The results were as follows: 1)Cardiac index was maintained more than 4L/min/m2 after ICU admission, 2)gastric pHi at 6 hours after ICU admission increased significantly (p<0.05) compared to the values at 12 and at 24 hours, 3)Shvo2 was about 60% with no significant change. Despite sufficient cardiac output, gastric mucosal blood flow decreased following open-heart surgery, and returned to the normal level within 24 hours. Hepatic blood flow showed the different course compared to pHi. These data suggest that gastric mucosal and hepatic blood flow are regulated by a different mechanism. We conclude that gastric pHi and Shvo2 may be useful for monitoring postoperative splanchnic circulation in patients after open-heart surgery. |
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| Practice | Basic medicine |
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| Keywords | Cardiopulmonary bypass, pHi, Hepatic vein |
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