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Current priming solutions for cardiopulmonary bypass contain a potent coronary vasodilator

Department of Surgery, North Shore University Hospital, Manhasset and Department of Surgery, Cornell Medical College, New York

Anthony J Tortolani

Department of Surgery, North Shore University Hospital, Manhasset and Department of Surgery, Cornell Medical College, New York

Melanie Maguine

Department of Surgery, North Shore University Hospital, Manhasset and Department of Surgery, Cornell Medical College, New York

Ferenc Czegledy

Department of Surgery, North Shore University Hospital, Manhasset and Department of Surgery, Cornell Medical College, New York

We studied the effects of acetate (Ac), the buffer in crystalloids used during cardiopulmonary bypass (CPB) (e.g. Normosol-R and Plasma-Lyte, Ac = 27mEq/1), on coronary resistance (R) for the empty beating heart, and on vascular resistance (SVR) of 19 dogs on CPB. Control Rwith Ac = 0 (R_c) was obtained by adjusting flow to give a pressure of 90 ± 10mmHg (R = 532 ± 32 dynes.sec/cm⁵g, other Rs are given as a percentage of their respective R_c) . Continuous addition of Ac = 1.6 or 7.1 mEq/L of blood resulted in a rapid decrease in R to 34 ± 3 and 17 ± 2% of R_c, followed by a recovery to higher steady values of 53 ± 3 and 27 ± 2% respectively (p < 0.008). A bolus administration of 2mEq and 6mEq into the coronary circuit resulted in R dropping to 30 ± 5 and 17 ± 6% respectively. Rs obtained with Ac were compared to the Rs obtained for control 20sec reactive hyperaemia (35 ± 1 %), after 30 minutes global ischaemia (14 ± 1 %), and with the addition of bicarbonate (98 ± 2%). Ac did not change heart rate, but caused an increase in O₂ consumption from 3.4 ± 0.4 to 4.8 ± 0.7ml/min/1 00g, (p < 0.038). Systemically, a bolus of 6mEq of Ac caused an immediate drop in SVR to 45 ± 5% of control. The property of Ac as a potent coronary and vascular dilator may need to be considered when Ac is used during cardiac surgery. Statistical comparisons were made with the paired t-test.

Perfusion, Vol. 5, No. 1, 9-21 (1990)
DOI: 10.1177/026765919000500103


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