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Pulsatile versus non-pulsatile perfusion in coronary artery bypass operation: The comparison of laboratory and
Farshad Jalili Shahandashti1, Sanaz Asadian1, Neda Habibi1
1Iranian Scientific Society Of Extracorporeal Technology, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Insights
Pulsatile perfusion during cardiopulmonary bypass (CPB) showed no significant benefits over non-pulsatile perfusion for coronary artery bypass graft (CABG) surgery outcomes. Different pulse rates did not alter clinical results or organ function markers.
Area of Science:
- Cardiovascular Surgery
- Cardiopulmonary Bypass Technology
- Clinical Trials
Background:
- The optimal method of cardiopulmonary bypass (CPB) perfusion, pulsatile versus non-pulsatile, remains a subject of debate in cardiac surgery.
- Investigating specific pulse rates in pulsatile CPB is crucial for optimizing patient outcomes in coronary artery bypass graft (CABG) procedures.
Purpose of the Study:
- To compare the clinical outcomes and biochemical markers of patients undergoing CABG using pulsatile CPB at different pulse rates (30 and 70 pulses/min) versus non-pulsatile CPB.
Main Methods:
- A randomized clinical trial involving 90 patients undergoing CABG.
- Patients were assigned to receive either pulsatile perfusion (30 or 70 pulses/min) or non-pulsatile perfusion.
- Evaluation of biochemical and clinical parameters in the intensive care unit (ICU).
Main Results:
- No statistically significant differences were observed in clinical outcomes, including kidney and liver function markers, between the groups.
- Serum lactate levels and urine output showed no significant variations across the study groups.
- Length of ICU stay was comparable among patients receiving pulsatile (30 or 70 pulses/min) and non-pulsatile perfusion.
Conclusions:
- Pulsatile perfusion, at the tested rates of 30 and 70 pulses per minute, offers no discernible advantage over non-pulsatile perfusion in selected CABG patients.
- The findings suggest that non-pulsatile CPB is a viable and equivalent option for selected CABG cases.
Introduction:
The superiority of pulsatile or non-pulsatile perfusion in cardiopulmonary bypass (CPB) regarding morbidity and mortality is still debated. Therefore, we aimed to investigate the effect of different pulse rates in pulsatile perfusion in patients undergoing coronary artery bypass graft (CABG) and compared it with non-pulsatile perfusion.
Materials And Methods:
In this randomized clinical trial, 90 patients who were all candidates for CABG under CPB were enrolled. Patients in groups A and B received pulsatile perfusion with 30 and 70 pulses per minute, and group C received non-pulsatile perfusion. The biochemical and clinical parameters in the ICU were evaluated in the study groups.
Results:
There was no statistically significant difference between patients' clinical outcomes and kidney and liver function markers (all Ps> 0.05). Mean serum lactate level increased but did not show a statistically significant difference between the study groups (p = 0.8). The mean urine volume at 12 and 24 h after surgery was higher in group A, but there was no statistically significant difference between the three groups during the study period (p = 0.3). No significant difference was found in the length of the ICU stay between the study groups (p = 0.2).
Conclusion:
Our studied parameters demonstrated no significant difference between pulsatile and non-pulsatile and between 30 and 70 pulse rate pulsatile perfusion methods. Our findings support that pulsatile perfusion with different pulse rates has no advantages over non-pulsatile perfusion in selected CABG cases.
