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The Effects of Citrated Blood and Hypothermia on Acid—Base Balance during Cardiopulmonary Bypass

Theoretically “predicted” acid-base changes were compared with “measured” changes in a study of 30 patients during cardiopulmonary bypass. The “predicted” extracellular buffer values were calculated on the assumption that simple mixing between the fluids used to prime the heart–lung machine and the patient's extracellular fluid occurred. Appropriate determinations made during bypass were used to calculate “measured” buffer base values. Both citrated and heparinized blood were used in the priming fluid at normal as well as reduced (30 C) body temperatures. Citrated blood raised the buffer base of the extracellular pool by a small but significant amount compared with heparinized blood. Buffer base was also slightly higher during normothermic bypass than during hypothermic bypass. The absence of severe acidosis was attributed mainly to the size and buffering capacity of the extracellular pool.