Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/10888
Title: Effect of pump prime on acidosis, strong-ion-difference and unmeasured ions during cardiopulmonary bypass.
Authors: Liskaser, F;Story, David A;Hayhoe, Matthew;Poustie, Stephanie J;Bailey, MJ;Bellomo, Rinaldo
Affiliation: Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia.
Issue Date: 1-Sep-2009
Citation: Anaesthesia and Intensive Care; 37(5): 767-72
Abstract: We tested the hypothesis that a cardiopulmonary bypass prime with lactate would be associated with less acidosis than a prime with only chloride anions because of differences in the measured strong-ion-difference. We randomised 20 patients to a 1500 ml bypass prime with either a chloride-only solution (Ringer's Injection; anions: chloride 152 mmol/l) or a lactated solution (Hartmann's solution; anions: chloride 109 mmol/l, lactate 29 mmol/l). Arterial blood was sampled before bypass and then two, five, 15 and 30 minutes after initiating bypass. We used repeated measures analysis of variance to compare groups. In both groups, the base-excess and measured strong-ion-difference decreased markedly from baseline after two minutes of bypass. The chloride-only group had greater acidosis with lower base-excess and pH (P < 0.05), greatest after five minutes of bypass (C5). Contrary to our hypothesis, however, the difference between the groups was not due to a difference in the measured strong-ion-difference, P = 0.88. At C5 when the difference in standard base-excess between the groups was greatest, 1.9 mmol/l (95% confidence interval: 0.1 to 3.6 mmol/l, P < 0.05), the difference in the measured strong-ion-difference was only 0.2 mmol/l (95% confidence interval: -2.4 to 2.7 mmol/l, P > 0.05). There was, however a difference in the net-unmeasured-ions (strong-ion-gap). We conclude that acid-base changes with cardiopulmonary bypass may differ with the prime but that the early differences between chloride-only and lactated primes appear not to be due to differences in the measured strong-ion-difference. We suggest future studies examine other possible mechanisms including unmeasured ions.
Internal ID Number: 19775041
URI: http://ahro.austin.org.au/austinjspui/handle/1/10888
URL: http://www.ncbi.nlm.nih.gov/pubmed/19775041
Type: Journal Article
Subjects: Acid-Base Equilibrium
Acidosis.metabolism
Aged
Analysis of Variance
Blood Gas Analysis
Cardiopulmonary Bypass
Female
Humans
Isotonic Solutions.administration & dosage
Lactic Acid.analysis
Male
Middle Aged
Serum Albumin.analysis
Thymol.administration & dosage
Treatment Outcome
Appears in Collections:Journal articles

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