Related Experiment Video
Updated: Jun 24, 2026
Pediatric Animal Model of Extracorporeal Cardiopulmonary Resuscitation After Prolonged Circulatory Arrest
Published on: May 26, 2023
Clinical application of pulsatile perfusion during cardiopulmonary bypass in pediatric heart surgery
Ju Zhao1, Jin-ping Liu, Zheng-yi Feng
1Departments of Cardiopulmonary Bypass, Fuwai Hospital and Cardiovascular Institution, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, People's Republic of China. zhaojucpb@hotmail.com
Insights
Pulsatile perfusion in pediatric cardiac surgery reduces inflammatory markers compared to nonpulsatile perfusion. This study shows benefits for congenital heart disease patients undergoing open heart surgery.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Biomedical Engineering
Background:
- The use of pulsatile versus nonpulsatile perfusion during cardiopulmonary bypass (CPB) in pediatric cardiac surgery remains a topic of debate.
- Congenital heart disease (CHD) in pediatric patients presents unique challenges during open heart surgery.
Purpose of the Study:
- To evaluate the effectiveness of pulsatile perfusion (PP) compared to nonpulsatile perfusion (NP) in pediatric patients with congenital heart disease undergoing open heart surgery.
- To assess the impact of PP on hemodynamic status and inflammatory markers.
Main Methods:
- A randomized study involving 24 pediatric patients with tetralogy of Fallot (TOF).
- Patients were divided into two groups: pulsatile perfusion (PP) and nonpulsatile perfusion (NP) groups.
- Hemodynamic status and inflammatory markers (IL-8, TNF-alpha, free plasma hemoglobin) were monitored over time.
Main Results:
- Pulsatile perfusion was successfully implemented, with significantly higher pulse pressure (DeltaP) in the PP group (p < 0.01).
- Inflammatory markers (IL-8, TNF-alpha) were lower in the PP group post-cross-clamp and during the intensive care unit period.
- Free plasma hemoglobin levels were higher in the PP group at pre-clamp off and CPB weaned off (p < 0.05).
Conclusions:
- Pulsatile perfusion is a viable technique for pediatric cardiac surgery.
- PP demonstrates a role in mitigating the concentration of inflammatory mediators in pediatric patients undergoing CPB.
Abstract:
The benefits of pulsatile over nonpulsatile perfusion has been widely debated in pediatric cardiac operations with cardiopulmonary bypass (CPB). To evaluate the role of pulsatile perfusion in pediatric complicated patients with congenital heart disease undergoing open heart surgery, we performed pulsatile CPB and compared several effects with nonpulsatile perfusion. Pediatric patients (n = 24) diagnosed as typical tetralogy of Fallot (TOF) were randomly divided into two groups: pulsatile perfusion (PP) group and nonpulsatile perfusion (NP) group. Pulsatile perfusion patients used modified roller pump PP during cross-clamping period in CPB, although NP cases used roller pump continuous flow perfusion during CPB. We monitored hemodynamic status and inflammatory media in blood samples over time in all patients. Effective PP can be monitored in PP patients and pulse pressure (DeltaP) was significantly higher in PP group than NP group (p < 0.01). Inflammatory media peaked at the time CPB was weaned off. In PP patients, IL-8 and TNF-alpha were lower after cross-clamp off and intensive care unit period than in NP cases. Free plasma hemoglobin concentration in PP group at preclamp off and CPB weaned off were higher than that of NP group (p < 0.05). Pulsatile perfusion can be successfully applied in pediatric perfusion. Pulsatile perfusion had the role of reducing concentration of inflammatory media in pediatric patients.
