OneHeartMender

lactic acidosis is a physiological condition characterized by low ph in body tissues and blood ([color=#0645ad]acidosis) accompanied by the buildup of [color=#0645ad]lactate especially [color=#0645ad]d-lactate, and is considered a distinct form of [color=#0645ad]metabolic acidosis.[color=#0645ad][1] the condition typically occurs when cells receive too little oxygen ([color=#0645ad]hypoxia), for example during vigorous exercise. in this situation, impaired cellular respiration leads to lower ph levels. simultaneously, cells are forced to metabolize [color=#0645ad]glucose [color=#0645ad]anaerobically, which leads to lactate formation. therefore, elevated lactate is indicative of tissue [color=#0645ad]hypoxia, [color=#0645ad]hypoperfusion, and possible damage. lactic acidosis is characterized by lactate levels >5 mmol/l and serum ph [/size][/size] norepinephrine constriction of small terminal arterioles, which is largely dependent on a2-receptors, was markedly reduced by acidosis. the data suggest that increases in local co2/h' concentration produced by altered parenchymal tissue metabolic rate, oxygen delivery, or blood ph may directly influence adrenergic responsiveness of microvessels by a selective action on a2-mediated constriction. http://circres.ahajournals.org/cgi/reprint/66/6/1643

Our CVICU has had pretty poor results with Precedex alone. If we run it with low dose Propofol it works pretty well. Most of our physicians do not prefer to use it. We are an academic university with > 800 beds. Most of the uncomplicated heart surgery patients are extubated within a six hour window of time. The aortic valve/aneurysms have been tried on Precedex and do not do well--still have pump head most of the time. We had someone on 1.7 mcg/kg/hr who still had 5 nurses holding him down until Propofol could be given.

Hi, just joined allnurses.com We also implant the Syncardia artificial heart. We also do implant or use extracorporeal devices--ECMO being the the extreme. I am curious as to what center uses the portable Syncardia console--sure would like to have that option. We have 3rd or 4th patient with the Syncardia now and the console is massive