12. DO 2 versus VO 2 VO 2 = 2 ml/kg DO 2 VO 2 : 80 kg HCT 24% VO 2 = 3 ml/kg

20. Lactate and Outcomes Adult Patients Demmers Ann Thorac Surg 70:2082-6:2000 A peak blood lactate level of >4.0 mmol/L during CPB was identified as a strong independent predictor of mortality and morbidity and suggests that occult tissue hypoperfusion occurred during CPB.

26. A-V PCO 2 Gradient (  PCO 2 ) Teboul. Crit Care Med 26;1007-1010:1998 Increasing cardiac output with dobutamine decreases  PCO2

27. Comparison of  PCO 2 versus SvO 2 Warm 1.7 L/m 2 1.9 L/m 2 HGB = 9 g/dl Art. Press = 70 mmHg

28. Comparison of  PCO 2 versus Temperature and Flow Rate 1.7 L/m 2 1.9 L/m 2 HGB = 8 g/dl Art. Press = 60-70 mmHg n= 50 Adult CABG

29. Comparison of SvO 2 versus Temperature and Flow Rate 1.7 L/m 2 1.9 L/m 2 HGB = 8 g/dl Art. Press = 60-70 mmHg n = 50 Adult CABG

38. Normal Autoregulation Drop in arterial pressure due to institution of CPB Restoration of blood flow

41. Normal Vasorelaxation NOS Relaxation PaCO 2 Acetylcholine Hypoxia ADP NO Vascular Endothelial Cell Vascular Smooth Muscle Cell NO is nitric oxide

42. Diabetic Vasorelaxation NOS Relaxation PaCO 2 Acetylcholine Hypoxia ADP NO Vascular Endothelial Cell Vascular Smooth Muscle Cell Thickened Basement Membrane Reduced NO Synthesis Uncoupled autoregulation in diabetic vasculature Pallas, Larson Perfusion.11;363-370:1996

45. DO 2 (Oxygen delivery) versus Hct 3 ml/kg 2 ml/kg Through increasing DO 2 with flow rate or hematocrit- the VO 2 demand can be achieved. VO 2 1 ml/kg