Despite the continued successful employment of the pump-oxygenators in hospitals throughout the world, the metabolic alterations associated with extracorporeal circulation remain a perplexing problem.10,26 The basic mechanisms responsible for these abnormalities have not been completely explained. The changes in vital organ metabolism (heart, brain, kidney, lung and liver) may well prove critical in certain instances, and an understanding of these alterations may be of considerable clinical importance. The etiology of the decreased myocardial function—the so-called cardiac hypotension—following cardiopulmonary bypass which occasionally results in the death of the patient, has been suspected of occurring as a result of metabolic alterations.8 Recent studies of some parameters of myocardial metabolism during cardiopulmonary bypass have been reported.23,36 Additional studies including evaluation of the known cardiac metabolites appear to be indicated, and an investigation of the utilization and production of several metabolites by the myocardium during and after prolonged extracorporeal circulation
WALLACE HW, RHEINLANDER HF, SUGARMAN HJ. Cardiac Metabolism During Extracorporeal Circulation. Arch Surg. 1961;82(1):138–146. doi:10.1001/archsurg.1961.01300070142017
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