Abstract
Before beginning the extracorporeal circulation, perfusionists should supply oxygen into the oxygenator and establish blood flow through the blood line of the heart-lung machine. But these manipulation can induce severe hypocarbic state of priming solutions due to wash out of $CO_2$ gas in the solution. This study was carried out to examine the relationship of blood gas changes between hypocarbic priming solutions and body circulation in 15 patients undergoing open heart surgery with extracorporeal circulation. $PaCO_2$, pH, buffer base and $PaO_2$ were measured from priming solutions before and 15 minutes after the extracorporeal circulation. The results were as follows; 1) Before the extracorporeal circulation, mean $PaCO_2$ level was $12.1{\pm}7.8mmHg$ in the priming solution. However, 15 minutes after extracorporeal circulation, the $PaCO_2$ level was maintained at $35.7{\pm}5.7mmHg$. 2) pH in the priming solution was variable from 6.93 to 7.99 (mean $7.45{\pm}0.29$), but after 15 minutes it was ranged from 7.28 to 7.42 (mean $7.35{\pm}0.05$). 3) Mean buffer base level in the priming solution was $7.9{\pm}3.5mmol/l$, but after 15 minutes, it was $19.6{\pm}1.2mmol/l$. 4) Mean $PaO_2$ level in the priming solution was $667.1{\pm}45.6mmHg$, but after 15 minutes, it was $280.7{\pm}131.7mmHg$.
체외순환전 심폐기내 충전액의 이산화탄소분압, 산도, 완충염기, 산소분압을 측정하고 저체온 체외 순환 15분후의 각각의 치를 측정하여 비교 분석한 결과 다음과 같은 결론을 얻었다. 1. 이산화단소분양은 충전액은 $12.1{\pm}7.8mmHg$로 매우 심한 저이산화탄소혈증 이었으나 체외순환 후 15분에서 $35.7{\pm}5.7mmHg$로 정상 범위이었다. 2. 산도는 충전액은 최저 pH 6.93, 최고 pH 7.99(평균 $7.45{\pm}0.29$)로 매우 심한 변동폭을 보였으나 체외순환후 15분에는 pH $7.35{\pm}0.05$로 정상범위이었다. 3. 완충염기는 충전액은 $7.9{\pm}3.5mmol/l$로 매우 낮았으나 체외순환후 15분에는 $19.6{\pm}1.2$로 정상치에 가깝게 유지되었다. 4. 산소분압은 충전액은 $667.1{\pm}45.6$으로 매우 심한 과산소혈증 이었으나 체외순환후 15분에는 $280.7{\pm}131.7$로 크게 감소되었다. 이상의 결과로 미루어 보아 체외순환전 심폐기내 충전액의 저이산화탄소분압 및 고산소분압 상태는 체외순환중 생체내에는 크게 영향을 마치지 않는것으로 사료된다.