“Washout” Acidosis following Resection of Aortic Aneurysms

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Abstract
Metabolic studies distal to the cross clamped aorta demonstrate: accumulation of significant amounts of acid metabolites as evidenced by a significant fall in venous pH; significant elevations in the absolute values of lactate and pyruvate and of excess lactate during occlusion; a profound fall in venous pO2[O2 tension] and venous O2 saturation; a precipitous tall in the specific gravity of the serum; that the effect of venous washout acidosis on arterial blood is minimal under circumstances of normo-volemia and adequate ventilation and oxygenation. The infusion of commercial Dextran above the cross clamp at the rate of 2.5 cc/kg body weight/hr. is effective in reducing anaerobic metabolism during the period of occlusion. This effect is probably secondary to enhanced capillary flow associated with Dextran infusion. The use of buffers (Na bicarbonate) would seem to be helpful in reducing the mortality rate associated with the resection of ruptured aortic aneurysms.