Effect Of Lipo-PGE1 On Gastrointestinal Perfusion In Patients Undergoing Cardiopulmonary Bypass Heart Surgery

Objective The pathophysiology of airframe systems change greatly in the patients undergoing open-heart surgery during cardiopulmonary bypass.People approached more on vital systems such as heart,brain,kidney than on gastrointestinal tract formerly.But now they have paid more attention to the changes of gastrointestinal infusion during cardiopulmonary bypass.This study was carried out to investigate the effect of cardiopulmonary bypass on gastrointestinal infusion by using gastric tonometry.And with the use of lipo-PGE1 ,we can also determine whether lipo-PGE1(kai shi injection)has the effect of gastrointestinal protection,improving microcirculation,decrease of concentration of endotoxin and TNF-a.We also discuss its mechanisms.Methods Thirty adult patients undergoing open-heart surgery of valve replacement were randomly divided into two equal groups of fifteen patients each:control group(C group)and Lipo-PGE1 group(K group).After induction of anesthesia, all patients were inserted the Tonometry Catheters(14F) nasogastrically. In K group Lipo-PGE1 10ug ( diluted to 50ml by normal saline) was infused at the rate of 0.04 ug/ kg/h by a microinfusion pump from the beginning of the operation to 6h after operation , while in group C normal saline(NS) was given instead of Lipo-PGE1. Patients with ejection fraction (EF) <0.45, gastrointestinal function disturbances and diabetes mellitus were excluded from this study.The Famotidine 20mg was given iv before anesthesia. The patients were induced with midazolam 0.2mg/kg, sufentanil 1μg/kg and vecuronium 0.1mg/kg and maintained with fentanyl,midazolam,vecuronium and isoflurane. The patients were mechanically ventilated after tracheal intubation and PetCO2 was maintained at 35-45mmHg.ABP,ECG,CVP,PetCO2,...