In patients undergoing open cardiac surgery there are substantial differences in acidbase balance, preoperatively, between acyanotic and cyanotic patients. Metabolic studies on patients undergoing total body perfusion by means of a bubble oxygenator show the arterial pH values for all 84 acyanotic patients were within the range of normal at the termination of the bypass, and in 31 cyanotic patients the arterial pH remained at the control level—somewhat acidotic. Other physiological responses have been measured to achieve the goal of providing for the patient an optimum perfusion volume plus a margin of safety to allow for biological variations. This goal is obtained by monitoring each bypass procedure by means of a continuous recording of the patient's electroencephalogram and systemic blood pressure, and adjusting thereafter the perfusion rate to keep these variables normal or near normal.
DeWall RA, Warden HE, Melby JC, Minot H, Varco RL, Lillehei CW. PHYSIOLOGICAL RESPONSES DURING TOTAL BODY PERFUSION WITH A PUMP-OXYGENATOR: STUDIES IN ONE HUNDRED TWENTY PATIENTS UNDERGOING OPEN CARDIAC SURGERY. JAMA. 1957;165(14):1788–1792. doi:10.1001/jama.1957.02980320018006
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