• Anesthesia and analgesia · May 2009

    Randomized Controlled Trial Comparative Study

    Jugular venous oxygenation during hypothermic cardiopulmonary bypass in patients at risk for abnormal cerebral autoregulation: influence of alpha-Stat versus pH-stat blood gas management.

    • Lance R Hoover, Radhika Dinavahi, Wei-Ping Cheng, John R Cooper, Maria Rosa Marino, Tyler C Spata, Gaile L Daniels, William K Vaughn, and Nancy A Nussmeier.
    • Department of Cardiothoracic Anesthesia, San Antonio Uniform Health Education Consortium, San Antonio, Texas, USA.
    • Anesth. Analg. 2009 May 1;108(5):1389-93.

    AbstractIn a prospective, randomized study of cardiac surgical patients at risk for impaired cerebral blood flow autoregulation, we compared alpha-stat and pH-stat blood gas management. The 40 patients enrolled had age >70 yr, diabetes, prior stroke, or uncontrolled hypertension. During hypothermia and early rewarming, jugular oxygen tensions were significantly lower in alpha-stat patients (n = 12) than pH-stat patients (n = 19; P < 0.05). During rewarming, jugular venous desaturation (i.e., SjvO(2) <50%) occurred in 6 of 12 alpha-stat patients, but no pH-stat patients (P = 0.0006). Patients at risk for poor cerebral autoregulation have higher oxygen tensions and saturations if pH-stat blood gas management is used during cardiopulmonary bypass.

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