Relationship between early gastric mucosal pH and cardiac function in infants with congenital heart disease undergoing cardiopulmonary bypass

doi:10.3877/cma.j.issn.1674-6880.2016.01.005

Abstract

Abstract:

Objective

To explore the relationship between early gastric mucosal pH and cardiac function in infants with congenital heart disease undergoing cardiopulmonary bypass.

Methods

A total of 18 infants with congenital heart disease undergoing cardiopulmonary bypass were enrolled in this study. The air tension meter method was used to dynamically detect the arterial partial pressure of CO₂ of gastric mucosal, and gastric mucosal pH was calculated. The gastric mucosal pH, cardiac index, oxygen saturation of mixed venose blood (SvO₂) and blood lactic acid at 0 h (T₁), 4 h (T₂), 8 h (T₃), 12 h (T₄), 24 h (T₅), 48 h (T₆) and 72 h (T₇) after surgical intensive care unit were recorded and compared. The Pearson correlation analysis was used to analyze the relationship between early gastric mucosal pH, SvO₂, blood lactic acid and cardiac index.

Results

The gastric mucosal pH, cardiac index, SvO₂ and blood lactic acid at different times all showed significant differences (F = 5.702, 8.225, 3.164, 13.051, all P< 0.05). The gastric mucosal pH at T₂ was 7.33 ± 0.07, lower than those at T₆ and T₇ (7.39 ± 0.06, 7.40 ± 0.06, all P < 0.05). The cardiac index at T₆ and T₇ were (4.32 ± 0.75) L·min^-1·m^-2, (4.24 ± 0.78) L·min^-1·m^-2 respectively, higher than those at T₁, T₂, T₃ and T₄ [(3.61 ± 1.09) L·min^-1·m^-2, (3.60 ± 1.06) L·min^-1·m^-2, (3.42 ± 0.87) L·min^-1·m^-2, (3.33 ± 0.94) L·min^-1·m^-2, all P < 0.05]. The level of SvO₂ at T₃ and T₄ were (71.7 ± 8.2)%, (72.3 ± 7.8)% respectively, lower than those at T₅, T₆ and T₇ [(79.9 ± 6.5)%, (78.5 ± 5.7)%, (78.1 ± 5.1)%, all P < 0.05]. And the levels of blood lactic acid at T₁ and T₂ were (1.77 ± 0.79) mmol/L, (1.72 ± 0.83) mmol/L, respectively, higher than those at T₃, T₄, T₅, T₆ and T₇ [(1.52 ± 0.89) mmol/L, (1.31 ± 0.45) mmol/L, (0.99 ± 0.35) mmol/L, (0.77 ± 0.23) mmol/L, (0.73 ± 0.18) mmol/L, all P < 0.05]. Meanwhile, the Pearson correlation analysis showed that the cardiac index was positively correlated with gastric mucosal pH and SvO₂ (r = 0.247, 0.419, all P< 0.05), and negative correlation with blood lactic acid (r = -0.318, P< 0.05).

Conclusion

The gastric mucosal pH, SvO₂ and blood lactic acid are associated with cardiac index, and can reflect the changes of cardiac function.

Key words: Extracorporeal circulation, Heart defects, congenital, Gastric mucosal pH, Infants

Caiyun Zhang, Zewei Zhang, Yunxiang Qiu, Jiajie Fan, Zhijie Zheng. Relationship between early gastric mucosal pH and cardiac function in infants with congenital heart disease undergoing cardiopulmonary bypass[J]. Chinese Journal of Critical Care Medicine(Electronic Edition), 2016, 09(01): 28-33.

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时间点	例数	胃黏膜pH值	心指数（L·min^-1·m^-2）	SvO₂(%)	血乳酸(mmol/L)
T₁	18	7.37 ± 0.06	3.61 ± 1.09	76 ± 10	1.77 ± 0.79
T₂	18	7.33 ± 0.07^a	3.60 ± 1.06	75 ± 12	1.72 ± 0.83
T₃	18	7.35 ± 0.08	3.42 ± 0.87	72 ± 8	1.52 ± 0.89^ab
T₄	18	7.37 ± 0.07	3.33 ± 0.94	72 ± 8	1.31 ± 0.45^ab
T₅	18	7.37 ± 0.07	3.89 ± 0.83	80 ± 6^cd	0.99 ± 0.35^abcd
T₆	18	7.39 ± 0.06^b	4.32 ± 0.75^abcde	78 ± 6^cd	0.77 ± 0.23^abcde
T₇	18	7.40 ± 0.06^b	4.24 ± 0.78^abcd	78 ± 5^cd	0.73 ± 0.18^abcde
F值	?	5.702	8.225	3.164	13.051
P值	?	0.044	< 0.001	0.007	< 0.001

时间点	例数	胃黏膜pH值	心指数（L·min^-1·m^-2）	SvO₂(%)	血乳酸(mmol/L)
T₁	18	7.37 ± 0.06	3.61 ± 1.09	76 ± 10	1.77 ± 0.79
T₂	18	7.33 ± 0.07^a	3.60 ± 1.06	75 ± 12	1.72 ± 0.83
T₃	18	7.35 ± 0.08	3.42 ± 0.87	72 ± 8	1.52 ± 0.89^ab
T₄	18	7.37 ± 0.07	3.33 ± 0.94	72 ± 8	1.31 ± 0.45^ab
T₅	18	7.37 ± 0.07	3.89 ± 0.83	80 ± 6^cd	0.99 ± 0.35^abcd
T₆	18	7.39 ± 0.06^b	4.32 ± 0.75^abcde	78 ± 6^cd	0.77 ± 0.23^abcde
T₇	18	7.40 ± 0.06^b	4.24 ± 0.78^abcd	78 ± 5^cd	0.73 ± 0.18^abcde
F值	?	5.702	8.225	3.164	13.051
P值	?	0.044	< 0.001	0.007	< 0.001

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