plasma acetate, gluconate and interleukin-6 profiles during and after cardiopulmonary bypass a comparison of plasma-lyte 148 with a bicarbonate-balanced solution等离子体酯、葡萄糖酸和白细胞介素- 6的资料期间和之后心肺旁路比较plasma-lyte 148 bicarbonate-balanced解决方案.pdfVIP

Davies et al. Critical Care 2011, 15:R21 /content/15/1/R21 RESEARCH Open Access Plasma acetate, gluconate and interleukin-6 profiles during and after cardiopulmonary bypass: a comparison of Plasma-Lyte 148 with a bicarbonate-balanced solution 1 2* 3 3 2 Paul G Davies , Balasubramanian Venkatesh , Thomas J Morgan , Jeffrey J Presneill , Peter S Kruger , 1 4 5 Bronwyn J Thomas , Michael S Roberts , Julie Mundy Abstract Introduction: As even small concentrations of acetate in the plasma result in pro-inflammatory and cardiotoxic effects, it has been removed from renal replacement fluids. However, Plasma-Lyte 148 (Plasma-Lyte), an electrolyte replacement solution containing acetate plus gluconate is a common circuit prime for cardio-pulmonary bypass (CPB). No published data exist on the peak plasma acetate and gluconate concentrations resulting from the use of Plasma-Lyte 148 during CPB. Methods: Thirty adult patients were systematically allocated 1:1 to CPB prime with either bicarbonate-balanced fluid (24 mmol/L bicarbonate) or Plasma-Lyte 148. Arterial blood acetate, gluconate and interleukin-6 (IL-6) levels were measured immediately before CPB (T1), three minutes after CPB commencement (T2), immediately before CPB separation (T3), and four hours post separation (T4). Results: Acetate concentrations (normal 0.04 to 0.07 mmol/L) became markedly elevated at T2, where the Plasma- Lyte group (median 3.69, range (2.46 to 8.55)) exceeded the bicarbonate group (0.16 (0.02 to 3.49), P 0.0005). At T3, levels had declined but the differential pattern remained apparent (Plasma-Lyte 0.35 (0.00 to 1.84) versus bicarbonate 0.17 (0.00 to 0