Significance of Correction of Metabolic Acidosis on the Cardiovascular Dynamics Experimental Study and Clinical Observation Following Cardiopulmonary Bypass

Shoji EGUCHI; Hisashi ISOGAWA; Masanori TERASHIMA; Kenichi ASANO

doi:10.1536/ihj.8.582

Significance of Correction of Metabolic Acidosis on the Cardiovascular Dynamics

Experimental Study and Clinical Observation Following Cardiopulmonary Bypass

Shoji EGUCHI, Hisashi ISOGAWA, Masanori TERASHIMA, Kenichi ASANO

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JOURNAL FREE ACCESS

1967 Volume 8 Issue 6 Pages 582-596

DOI https://doi.org/10.1536/ihj.8.582

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Published: 1967 Received: April 24, 1967 Available on J-STAGE: December 09, 2008 Accepted: - Advance online publication: - Revised: -
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Date of correction: December 09, 2008 Reason for correction: - Correction: ABSTRACT Details: Wrong : The cardiovascular effects of metabolic acidosis and alkalosis and its correction were studied experimentally and clinically.
Metabolic acidosis induced by HCl resulted in a depression in VCF and ventricular function curve. When cardiac output was controlled to be constant, metabolic acidosis resulted in a reduction of systemic vascular resistance and a concurrent increase of pulmonary vascular resistance. These cardiovascular derangements were manifested below a pH of 7.2 and reversible by correction of metabolic acidosis. Correction of metablolic acidosis after open-heart surgery usually improved myocardial performance.
Right : The importance of correction of acid-base derangement for the care of surgical patient has been stressed recently. Despite of intensive study of the hemodynamic aspects of its derangement, these results were not entirely consistent. Accordingly, evaluations were made concerning the influence of metabolic acidosis and its correction on myocardial performance and vascular resistance in dogs and clinically the effectiveness of correction of metabolic acidosis on myocardial contractility after an openheart surgery. The result indicated that metabolic acidosis had a considerably adverse effect on the myocardium and the peripheral circulation, and that correction of metabolic acidosis was quite beneficial to restore cardiovascular dynamics.

Date of correction: December 09, 2008 Reason for correction: - Correction: AFFILIATION Details: Wrong :
1) Department of Thoracic and Cardiovascular Surgery, University of Niigata

Right :
1) the Department of Thoracic and Cardiovascular Surgery, University of Niigata

Date of correction: December 09, 2008 Reason for correction: - Correction: CITATION Details: Wrong : 1. Boniface, K.J., Brodie, O.J., and Walton, R.P.: Proc.Soc.Exp.Biol.Med. 84:263, 1953.
2. Eguchi, S. and Bosher, L.H., Jr.: Surgery 51:103, 1962.
3. Price, H.L. and Helrich, M.: J.Pharm.Exp.Ther. 115:206, 1955.
4. McElroy, W.T., Jr., Gerdes, A.J., and Brown, E.B., Jr.: Am.J.Physiol. 195:412, 1958.
5. Darby, T.D. et al.: Circulat. Res. 8:1242, 1960.
6. Thrower, W.R., Darby, T.D., and Aldinger, E.E.: Arch.Surg. 82:56, 1961.
7. Wang, H. and Katz, R.L.: Circulat. Res. 17:114, 1965.
8. Andersen, M.N. and Mouritzen, C.: Ann.Surg. 163:161, 1966.
9. Downing, S.E., Talner, N.S., and Gardner, T.H.: Am.J.Physiol. 208:237, 1965.
10. LeVeen, H.H. et al.: Surgery 51:360, 1962.
11. Smith, N.T. and Corbascio, A.N.: Arch. Surg. 92:892, 1966.
12. Goodyer, A.V.N., Goodkind, M.J., and Stanley, E.J.: Am.HeartJ. 67:779, 1964.
13. Clowes, G.H.A., Jr. et al.: Ann.Surg. 154:524, 1961.
14. Kittle, C., Aoki, H., and Brown, E.B., Jr.: Surgery 57:139, 1965.
15. Gotten, M.de V. and Bay, E.: Am.J.Physiol. 187:122, 1956.
16. Richardson, D.W., Wasserman, A.J., and Patterson, J.L.: J.Glin.Invest. 40:31, 1961.
17. Maim, J.R. et al.: J.A.M.A. 197:161, 1966.
18. Rowe, G.G. et al.: Anesthesiology 25:317, 1964.
19. Baue, A.E. and McClerkin, W.W.: Ann.Surg. 161:41, 1965.
20. Simeone, F.A.: Am.J.Cardiol. 13:589, 1963.
21. Coles, J.C., Gergerly, N.F., and Carroll, S.E.: Canad. J.Surg. 6:206, 1963.
22. Hassam, D. et al.: Surg.Forum 12:85, 1961.
23. Bergentz, S.E. and Brief, D.K.: Surgery 58:412, 1965.
24. Selmonosky, C.A., Goetz, R.H., and State, D.: Surg.Gynec.Obst. 112:724, 1961.
25. Nelson, R.M. et al.: Surgery 54:86, 1963.
26. Carrier, O., Jr. et al.: Am.J.Physiol. 207:169, 1964.
27. Liljestrand, G.: Acta physiol.Scand. 44:216, 1958.

Right : 1. Boniface, K. J., Brodie, O. J., and Walton, R. P.: Proc. Soc. Exp. Biol. Med. 84: 263, 1953.
2. Eguchi, S. and Bosher, L. H., Jr., Surgery 51: 103, 1962.
3. Price, H. L. and Helrich, M.: J: Pharm. Exp. Ther. 115: 206, 1955.
4. McElroy, W. T., Jr., Gerdes, A. J., and Brown, E. B.,Jr.: Am. J. Physiol. 195: 412, 1958.
5. Darby, T. D. et al.: Circulat. Res. 8: 1242, 1960.
6. Thrower, W. R., Darby, T. D., and Aldinger, E.E.: Arch. Surg. 82: 56, 1961.
7. Wang, H. and Katz, R.L: Circulat. Res.17: 114, 1965.
8. Andersen, M. N. and Mouritzen, C: Ann. Surg. 163: 161, 1966.
9. Downing, S. E., Talner, N. S., and Gardner, T. H.: Am. J. Physiol. 208: 237, 1965.
10. LeVeen, H. H. et al: Surgery 51: 360, 1962.
11. Smith, N.T. and Corbascio, A.N., Arch. Surg. 92: 892, 1966.
12. Goodyer, A. V. N., Goodkind, M.J., and Stanley, E.J: Am. Heart J. 67:779, 1964.
13. Clowes, G. H. A., Jr. et al., Ann. Surg. 154: 524, 1961.
14. Kittle, C., Aoki, H., and Brown, E. B., Jr.: Surgery 57: 139, 1965.
15. Cotten, M. de V. and Bay, E.: Am. J. Physiol. 187: 122, 1956.
16. Richardson, D. W., Wasserman, A. J., and Patterson, J. L.: J. Clin. Invest. 40: 31, 1961.
17. Malm, J. R. et al: J.A.M.A. 197: 161, 1966.
18. Rowe, G. G. et al., Anesthesiology 25: 317, 1964.
19. Baue, A. E. and McClerkin, W. W.: Ann. Surg. 161: 41, 1965.
20. Simeone, F. A.: Am. J. Cardiol. 13: 589, 1963.
21. Coles, J. C., Gergerly, N. F., and Carroll, S. E.: Canad. J. Surg. 6: 206, 1963.
22. Hassam, D. et al.: Surg. Forum 12: 85, 1961.
23. Bergentz, S. E. and Brief, D. K.: Surgery 58: 412, 1965.
24. Selmonosky, C.A., Goetz, R. H., and State, D., Surg. Gynec. Obst.112: 724, 1961.
25. Nelson, R. M. et al: Surgery 54: 86, 1963.
26. Carrier, O., Jr.et al.: Am.J.Physiol. 207: 169, 1964.
27. Liljestrand, G.:Acta physiol. Scand. 44:216, 1958.

Date of correction: December 09, 2008 Reason for correction: - Correction: PDF FILE Details: -

Abstract

The importance of correction of acid-base derangement for the care of surgical patient has been stressed recently. Despite of intensive study of the hemodynamic aspects of its derangement, these results were not entirely consistent. Accordingly, evaluations were made concerning the influence of metabolic acidosis and its correction on myocardial performance and vascular resistance in dogs and clinically the effectiveness of correction of metabolic acidosis on myocardial contractility after an openheart surgery. The result indicated that metabolic acidosis had a considerably adverse effect on the myocardium and the peripheral circulation, and that correction of metabolic acidosis was quite beneficial to restore cardiovascular dynamics.

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