Hemodynamic and metabolic effects of aortic unclamping following emergency surgery for traumatic thoracic aortic tear in shunted and unshunted patients.

摘要: Nine cases of traumatic aortic tear treated during 1986-1987 were reviewed. Two patients had functioning Gott shunts, six simple crossclamp, and one patient a shunt placed which was nonfunctional. Anesthetic management similar in all patients. Clamp times ranged unshunted from 25 to 38 minutes, shunted 42 50 minutes. The crossclamp time the with nonfunctional Declamping accompanied by decreases core temperature up 1 degree C acute PaO2. Marked respiratory metabolic acidosis occurred declamping. Respiratory resolved within 30 minutes hyperventilation, but persisted despite bicarbonate therapy (mean = 1.2 mEq/kg) 6 hours after Associated elevations serum potassium as pH returned baseline. Acid-base electrolyte abnormalities less marked who shunted.