کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
2981706 1578633 2012 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
The relationship between plasma concentrations of ionized calcium and magnesium with cardiac energetics and systemic oxygen transport in neonates after the Norwood procedure
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی کاردیولوژی و پزشکی قلب و عروق
پیش نمایش صفحه اول مقاله
The relationship between plasma concentrations of ionized calcium and magnesium with cardiac energetics and systemic oxygen transport in neonates after the Norwood procedure
چکیده انگلیسی

ObjectiveWe sought to determine the relationship between plasma calcium and magnesium concentrations with postoperative systemic hemodynamics and oxygen transport in neonates after the Norwood procedure.MethodsPostoperative systemic oxygen consumption was continuously measured using respiratory mass spectrometry for 72 hours in 17 neonates. Arterial, superior vena caval and pulmonary venous blood gases and pressures, plasma calcium, and lactate levels were measured at 2- to 4-hour intervals to calculate cardiac output, rate pressure product, cardiac power output, systemic oxygen delivery, and oxygen extraction ratio. Plasma magnesium levels were measured at 2- to 8-hour intervals.ResultsPlasma calcium levels decreased in the first 8 hours from 1.08 ± 0.13 mmol/L to 0.98 ± 0.08 mmol/L, followed by an increase to 1.10 ± 0.26 mmol/L at 72 hours (P < .0001). Mg2þ change was significantly related to time after logarithmic transformation, rapidly decreasing from 1.62 ± 0.25 mg/L to 0.90 ± 0.15 mg/L in the first 40 hours and further decreasing slowly thereafter to 0.64 ± 0.13 mg/L at 72 hours (P < .0001). Plasma magnesium levels had a significant positive correlation with cardiac output (P = .008) and cardiac power output (P = .01), and a negative correlation with heart rate (P = .05). Plasma magnesium levels correlated positively with systemic oxygen delivery and negatively with systemic oxygen consumption (P = .08 for both), resulting in significant negative correlations with oxygen extraction ratio (P = .04) and lactate levels (P = .05). For a given cardiac power output, plasma magnesium showed a significantly negative correlation with rate pressure product (P = .01). Plasma calcium levels showed the opposite trend, which was statistically insignificant except for lactate (P = .007).ConclusionsPlasma magnesium may exert favorable effects on myocardial energetics and systemic oxygen transport in neonates after the Norwood procedure, whereas plasma calcium may be harmful. Maintaining a relatively high level of plasma magnesium and a low level of plasma calcium may improve myocardial work efficiency and the balance of systemic and myocardial oxygen transport.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Thoracic and Cardiovascular Surgery - Volume 144, Issue 2, August 2012, Pages 474–479
نویسندگان
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