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Does Roller Pump-Induced Pulsatile CPB Perfusion Affect Microvascular Fluid Shifts and Tissue Perfusion?
Bjørg Elvevoll1, Steinar Lundemoen2, Øyvind S Svendsen1
1Department of Anesthesia and Surgical Services, Haukeland University Hospital, Bergen, Norway.
The Annals of Thoracic Surgery
|May 4, 2016
Summary
Pulsatile cardiopulmonary bypass (CPB) did not significantly differ from nonpulsatile CPB in fluid balance or tissue perfusion, despite some ventricular differences. This suggests no major benefits of pulsatile CPB for these outcomes.
Area of Science:
- Cardiovascular Surgery
- Physiology
- Biomedical Engineering
Background:
- The debate continues regarding the benefits of pulsatile versus nonpulsatile cardiopulmonary bypass (CPB) perfusion.
- Previous studies suggest pulsatile perfusion may improve tissue perfusion and microvascular fluid exchange, but findings are inconsistent.
Purpose of the Study:
- To evaluate fluid extravasation and tissue perfusion during pulsatile versus nonpulsatile roller pump-induced CPB.
Main Methods:
- Fourteen pigs underwent 90 minutes of either pulsatile or nonpulsatile CPB.
- Measurements included fluid balance, colloid osmotic pressures, hematocrit, electrolytes, proteins, tissue perfusion, and tissue water content.
Main Results:
- No significant differences were observed in fluid additions/losses, plasma volume, or fluid extravasation between the pulsatile and nonpulsatile CPB groups.
- Tissue perfusion and total tissue water content were similar, except for a reduction in right and left ventricular water content in the pulsatile group.
Conclusions:
- Pulsatile and nonpulsatile CPB perfusion showed no significant differences in microvascular fluid balance or tissue perfusion.
- The study found no important advantages of pulsatile CPB over nonpulsatile CPB for the evaluated parameters.
