Related Experiment Video
Updated: Jun 6, 2026
Increasing Pulmonary Artery Pulsatile Flow Improves Hypoxic Pulmonary Hypertension in Piglets
Published on: May 11, 2015
Pulsatile flow improves cerebral blood flow in pediatric cardiopulmonary bypass
Wei Wang1, Shu-Ying Bai, Hai-Bo Zhang
1Department of Pediatric Thoracic and Cardiovascular Surgery, Shanghai Children's Medical Center, School of Medicine Shanghai Jiao Tong University, Shanghai, China.
Insights
Pulsatile perfusion during cardiopulmonary bypass in infants may enhance cerebral blood flow (CBF) and reduce cerebral vascular resistance. This study compared pulsatile versus non-pulsatile flow in infants undergoing heart surgery.
Area of Science:
- Cardiovascular Surgery
- Pediatric Cardiology
- Neurocritical Care
Background:
- Mild hypothermic cardiopulmonary bypass (CPB) is used in infant open-heart surgery.
- Maintaining adequate cerebral blood flow (CBF) during CPB is crucial for neurological outcomes.
- The impact of pulsatile versus non-pulsatile flow on CBF in infants undergoing CPB requires further investigation.
Purpose of the Study:
- To evaluate the effect of pulsatile perfusion on cerebral blood flow (CBF) in infants undergoing mild hypothermic cardiopulmonary bypass (CPB).
Main Methods:
- Thirty infants undergoing open-heart surgery were randomized into pulsatile (Group P) and non-pulsatile (Group NP) perfusion groups.
- Cerebral blood flow parameters, including middle cerebral artery velocities and resistance indices, were measured using transcranial Doppler ultrasound at multiple time points.
- Measurements were taken at baseline, during CPB, after aortic cross-clamping, and at the end of the operation.
Main Results:
- Pulsatile perfusion (Group P) showed significantly higher systolic peak velocity (Vs) during aortic cross-clamping compared to non-pulsatile perfusion (Group NP).
- During CPB cessation, Group P exhibited higher end-diastolic velocity (Vd) and mean velocity (Vm), with lower pulsatility index (PI) and resistance index (RI) compared to Group NP.
- No significant differences in CBF parameters were observed at the end of the operation (T6) between the groups.
Conclusions:
- Pulsatile perfusion may transiently increase CBF and decrease cerebral vascular resistance in the early period after mild hypothermic CPB in infants.
- Further research is needed to determine the long-term neurological implications of pulsatile perfusion in this population.
Abstract:
The objective of this study was to evaluate the effect of pulsatile flow on cerebral blood flow (CBF) in infants with the use of a mild hypothermic cardiopulmonary bypass (CPB). Thirty infants scheduled for open heart surgery were randomized to the pulsatile group (Group P, n = 15) and nonpulsatile group (Group NP, n = 15). In Group P, pulsatile perfusion was applied during the aortic cross-clamping period, whereas nonpulsatile perfusion was used in Group NP. The systolic peak velocity (Vs), the end of diastolic velocity (Vd), the mean velocity (Vm), and the pulsatility index (PI) and the resistance index (RI) of the middle cerebral artery were measured by a transcranial Doppler (TCD) ultrasound after anesthesia (T1; baseline), at the beginning of CPB (T2), 10 min after aortic cross-clamping (T3), 3 min after declamping (T4), at the cessation of CPB (T5), and at the end of the operation (T6). During T3 and T4, the Vs in Group P was significantly higher than in Group NP. However, there were no statistically significant differences between Vd and Vm. The PI and RI in Group P were also higher than those in Group NP (both P < 0.05). During T5, Vd and Vm were higher in Group P (P < 0.05), whereas there was no difference in Vs. Additionally, PI and RI in Group P were significantly lower than those in Group NP (P < 0.05). However, there was no difference during T6. Pulsatile perfusion may increase CBF and decrease cerebral vascular resistance in the early period after mild hypothermic CPB.
