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Urethral blood circulation during cardiopulmonary bypass
M Talja1, A Lehtola, M Salmenperä
1Department of Surgery, Päijät-Häme Central Hospital, Lahti, Finland.
British Journal of Urology
|April 1, 1991
Summary
Extracorporeal circulation (ECC) significantly reduces urethral blood flow, increasing the risk of urethral strictures. This finding highlights the impact of circulatory changes on catheter-induced injuries during surgery.
Area of Science:
- Cardiovascular Surgery
- Urology
- Physiology
Background:
- Urethral strictures are a potential complication following open heart surgery using extracorporeal circulation (ECC) and indwelling latex catheters.
- Haemodynamic alterations during ECC are suspected to contribute to the development of these strictures.
Purpose of the Study:
- To investigate the specific changes in urethral mucosal and submucosal blood circulation during ECC.
- To correlate these haemodynamic changes with the risk of urethral stricture formation.
Main Methods:
- Six piglets were cannulated and connected to an extracorporeal perfusion apparatus, simulating human ECC conditions.
- Pump flows were adjusted to match human ECC values using a non-haemic prime.
- Urethral mucosal and submucosal blood circulation, as well as renal, brain, and hepatic arterial flows, were monitored.
Main Results:
- A significant 66% reduction in urethral mucosal and submucosal blood circulation was observed during ECC (P < 0.05).
- Brain and hepatic arterial flows increased, while renal blood circulation showed a significant reduction.
- Observed urethral blood flow changes during ECC align with previous research findings.
Conclusions:
- Reduced urethral blood circulation during ECC is a key factor in the induction of urethral strictures.
- Decreased local blood flow impairs the washout of chemicals leaching from indwelling latex catheters, initiating stricture formation.
- These findings are relevant to understanding urethral strictures in ECC and other shock-like circulatory disturbances.