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Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets
Published on: May 11, 2015
Pulsatile versus nonpulsatile cardiopulmonary bypass flow: an evidence-based approach
Abdullah A Alghamdi1, David A Latter
1Division of Cardiac Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada. abdullah.alghamdi@utoronto.ca
Journal of Cardiac Surgery
|July 19, 2006
Summary
Pulsatile perfusion (PP) shows conflicting evidence for reducing mortality and myocardial infarction after coronary artery bypass grafting (CABG). Insufficient evidence exists to recommend PP for reducing stroke or renal failure risks.
Area of Science:
- Cardiovascular Surgery
- Medical Technology Assessment
Background:
- Coronary artery bypass grafting (CABG) is a common surgical procedure.
- The use of pulsatile perfusion (PP) during cardiopulmonary bypass is debated for its potential benefits.
Purpose of the Study:
- To develop evidence-based recommendations on the efficacy of pulsatile perfusion (PP) in reducing mortality and complications following elective CABG surgery.
Main Methods:
- A systematic literature search was conducted across Medline, Embase, and the Cochrane controlled trial register up to March 2005.
- Studies were evaluated based on a priori inclusion and internal validity criteria.
Main Results:
- One fair-quality randomized controlled trial (RCT) suggested a benefit of PP in reducing total mortality and myocardial infarction (MI).
- No studies demonstrated a benefit of PP in reducing stroke or renal failure.
- One RCT indicated increased hemolysis with PP compared to nonpulsatile (NP) perfusion.
Conclusions:
- Conflicting evidence prevents recommendations for or against routine PP use to reduce mortality or MI after CABG.
- Insufficient evidence exists to recommend PP for reducing stroke or renal failure incidence.
