[Arterio-coronary venous difference in lactate concentration--a new objective and topical available parameter for the estimation of the energy metabolism status of the heart].

Zeitschrift fur experimentelle Chirurgie, Transplantation, und kunstliche Organe : Organ der Sektion Experimentelle Chirurgie der Gesellschaft fur Chirurgie der DDR Pub Date : 1990-01-01

H G Wollert, W Müller, D Fischer, U Wollert, R Panzner

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Abstract

Cardiosurgical operations were tested experimentally by means of a perioperative metabolic-energetic monitoring and by the conventional method of the hemodynamic monitoring (Swan-Ganz-catheter). By that could be shown that a perioperative monitoring by means of the arterio-coronary venous difference of the lactate level is possible. Intraoperative information about the topical metabolic-energetic condition of the myocardium is to receive as the decisive advantage of this method. An improvement of the therapy results is possible in that way by an optimum of the treatment. A metabolic recovery of the heart during the operation was substantial more favourable for the postoperative myocardial restitution than an early application of catecholamins. This method for perioperative observation should be used specially in risk operations (NYHA-stadium III-IV, reoperations, etc.).

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[动脉-冠状静脉乳酸浓度的差异——一个新的客观和局部可用的参数来估计心脏的能量代谢状态]。

通过围手术期代谢-能量监测和常规血流动力学监测方法(swan - ganz导管)对心外科手术进行实验测试。由此可见，通过动脉-冠状静脉乳酸水平差的围手术期监测是可行的。术中有关局部心肌代谢-能量状况的信息是该方法的决定性优势。通过对治疗方法进行优化，可以以这种方式改善治疗结果。手术期间心脏的代谢恢复比早期应用儿茶酚胺更有利于术后心肌恢复。这种围手术期观察方法尤其适用于高危手术(NYHA-stadium III-IV、再手术等)。

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Zeitschrift fur experimentelle Chirurgie, Transplantation, und kunstliche Organe : Organ der Sektion Experimentelle Chirurgie der Gesellschaft fur Chirurgie der DDR

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