About post-extracorporeal circulation metabolic acidosis and its treatment by perfusionist.

Abstract

Metabolic acidosis during cardiopulmonary bypass has multifactorial origin, so the perfusionist must know the mechanisms involved in its appereance, as well as the appropiate strategies to reduce this complication. It is of vital importance to use adequate perfusión and myocardial protection techniques. Consider the total volumen (the pump volumen and the patients circulatory volume), avoid excessive fluid administration, adequate use of ultrafiltration and the rational use of bicarbonate, with frequent measurements during cardiopulmonary bypass. The inadequate use of bicarbonate can lead to hemodynamic, respiratory, renal, metabolic and neurological complications in the short and medium term; which contribute to prolong the time in mechanical ventilation and the stay at the intensive care unit.