Organ hierarchy during low blood flow on-pump: a randomized experimental positron emission tomography study

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Introduction Higher co-morbidity, age and weight of the patients scheduled for today’s cardiac surgery question the precalculation of blood flow during cardiopulmonary bypass (CPB) [1]. Approximately 10-20 % of the cardiac surgery patients suffer from hyperlactatemia indicating tissue hypoxia [2].The purpose of this animal study is to investigate the organ hierarchy of brain, liver, kidney and muscle at normal and low blood flows by using dynamic positron tomography (PET-CT) during CPB. Methods CPB at different blood flows will be investigated in an experimental model of six 70 kg pigs; normothermic CPB with a blood flow of 2.5 L/min/m2 for one hour followed by a randomisation to a blood flow of either 2.0 L/min/m2 (Group I) or 1.5 L/min/m2 (Group II) for another hour and finally one hour with blood flow of 2.5 L/min/m2. Regional tissue perfusion of brain, liver, kidney, and muscle will be measured with dynamic PET-CT before CPB and during the different blood flows. Systemic oxygen consumption will be estimated by measurement of mixed venous saturation and lactate, and regional muscle oxygen saturation (tSO2) with near infrared spectroscopy at the lower limb. Result: Preliminary data indicates existence of an organ hierarchy with persevered perfusion of the brain but affected muscle tissue perfusion in in both Groups of suboptimal blood flow. The finally results will be ready for presentation at DASAIM 2014 in November. Non-parametric statistical method will be used. Discussion To our knowledge this is the first study investigating organ hierarchy with dynamic PET-CT during profound systemic ischemia due to suboptimal blood flows during normothermic CPB. References 1. Murphy JM, Hessel II EA, Groom RC. Optimal perfusion during cardiopulmonary bypass: an Evidence-based approach. Anesth & Analg 2009; 108: 1394-1417. 1. Ranucci M, De Toffol B, Isgro G, Romitti F, Conti D and Vicentini M. Hyperlactatemia during cardiopulmonary bypass: determinants and impact on postoperative outcome. Crit Care 2006; 10: R167.
Original languageEnglish
Publication year13 Nov 2014
Publication statusPublished - 13 Nov 2014
EventDASAIM Årsmøde - København, Denmark
Duration: 13 Nov 201415 Nov 2014

Conference

ConferenceDASAIM Årsmøde
CountryDenmark
CityKøbenhavn
Period13/11/201415/11/2014

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