This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Toshio Onitsuka Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Nakamura, K. Articles by Yano, Y. Search for Related Content PubMed PubMed Citation Articles by Nakamura, K. Articles by Yano, Y. Related Collections Cardiac - other Extracorporeal circulation

Study in three different types of cardiopulmonary bypass on arterial ketone body ratio: its prognostic implication and participation of body temperature

The Department of Surgery 2, Miyazaki Medical College, 5200, Kihara, Kiyotake, Miyazaki 889-1692, Japan

^* Corresponding author. Tel.: +81-985-85-2291; fax: +81-985-85-5563
shiori{at}post1.miyazaki-med.ac.jp

The aim of this study was to investigate the change of hepatic metabolic activity presented by the ketone body ratio (AKBR) during and after cardiopulmonary bypass (CPB) and to evaluate the prognostic value. AKBR were measured in 20 cases of coronary aortic bypass grafting using moderate hypothermic CPB (group M), ten cases of aortic arch surgery using deep hypothermia with selective cerebral perfusion (DHSCP) with an open technique (group D) and 15 cases of descending thoracic aortic replacement using partial CPB (group N). AKBR decreased significantly in all groups 5 min after CPB compared with the value before CPB. There was a significant difference in AKBR 1 h after CPB among the three groups and AKBR returned to the prebypass value in group N (group M, 0.32±0.16; group D, 0.14±0.04; group N, 0.48±0.14; ). AKBR rose significantly after the discontinuation of CPB compared with the value during CPB and returned to the prebypass value in groups M and D. The patients who underwent DHSCP with an open technique had a value of AKBR below 0.2, but liver function still recovered normally. The value of AKBR correlated with temperature significantly and a very low level of AKBR below 0.2 was observed during core cooling to 20 °C without negative prognostic implications. AKBR decreased 5 min after CPB in group N which suggested decreased hepatic perfusion at an early stage of partial CPB. The prognostic implication of AKBR during CPB is whether low level AKBR recovers or not.

Key Words: Arterial ketone body ratio; Hepatic metabolism; Cardiopulmonary bypass; Deep hypothermia

This article has been cited by other articles:

				T. Kunihara, N. Shiiya, S. Wakasa, K. Matsuzaki, and Y. Matsui Assessment of hepatosplanchnic pathophysiology during thoracoabdominal aortic aneurysm repair using visceral perfusion and shunt Eur. J. Cardiothorac. Surg., April 1, 2009; 35(4): 677 - 683. [Abstract] [Full Text] [PDF]