Clinical science
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Randomized Controlled Trial Clinical Trial
The effect of glutamate infusion on cardiac performance is independent of changes in metabolism in patients undergoing routine coronary artery bypass surgery.
In a double-blind randomized placebo-controlled study, the effects of intravenous glutamate infusion on myocardial haemodynamics and metabolism were studied in 22 patients undergoing routine coronary artery bypass graft (CABG) surgery. Immediately after aortic cross-clamp release, an intravenous infusion of a solution of glutamate (125 mmol x l(-1)) at a rate of 1.5 ml x h(-1) x kg(-1) was given over 1 h to 11 patients (G group). The other 11 patients received a placebo infusion (0.9% NaCl) (P group). ⋯ These data show that an intravenous glutamate infusion after routine CABG surgery significantly improved cardiac haemodynamic performance without direct effects on cardiac substrate metabolism. This suggests that a reduction of the afterload via a peripheral vasodilatory effect is the main mechanism leading to the observed changes in haemodynamics. Earlier claims that patients with post-operative cardiac failure show metabolic benefits from the glutamate infusion do not seem to apply to patients undergoing routine CABG surgery.
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Comparative Study
Comparison of two spatially resolved near-infrared photometers in the detection of tissue oxygen saturation: poor reliability at very low oxygen saturation.
Two spatially resolved oximeters, NIRO-300 and OM-200, were compared with regard to the measurement of oxygen saturation values in two forearm muscle groups at rest and during arterial occlusion in nine healthy volunteers. There was a significant correlation between the muscle oxygen saturation values obtained at rest using the two oximeters (n=33, r(2)=0.43, P<0.0001), whereas these values were significantly different during arterial occlusion. Thus, although there was good agreement between muscle oxygen saturation values measured using the two oximeters, the operating range of the tissue oximeters should be recognized and indicated.