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Pulsatile flow during routine cardiopulmonary bypass.

I S Chiu, S H Chu, C R Hung

    The Journal of Cardiovascular Surgery
    |November 1, 1984
    PubMed
    Summary
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    Pulsatile flow during cardiopulmonary bypass (CPB) stabilizes blood pressure and vascular resistance. This pulsatile flow also improves renal and hepatic function in patients undergoing heart surgery.

    Area of Science:

    • Cardiovascular Surgery
    • Physiology

    Background:

    • Cardiopulmonary bypass (CPB) is a critical procedure in open heart surgery.
    • The hemodynamic effects of pulsatile versus non-pulsatile flow during CPB are not fully understood.
    • Maintaining stable physiological parameters during CPB is crucial for patient outcomes.

    Purpose of the Study:

    • To investigate the impact of pulsatile flow during CPB on hemodynamic stability.
    • To evaluate the effects of pulsatile flow on renal and hepatic function during CPB.
    • To compare physiological responses between pulsatile and non-pulsatile CPB in cardiac surgery patients.

    Main Methods:

    • Two groups of 11 patients undergoing valvular and congenital heart surgery were studied.
    • One group received pulsatile flow CPB, while the other received non-pulsatile flow CPB.

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  • Hemodynamic parameters (BP, SVRI), oxygen consumption, carbon dioxide production, urine flow, and liver enzymes (sGOT) were monitored.

    • Main Results:

    • Non-pulsatile CPB led to a significant increase in systemic vascular resistance index (SVRI) after 40 minutes compared to pulsatile CPB.
    • Oxygen consumption and carbon dioxide production appeared lower in the non-pulsatile group, though not statistically significant.
    • Pulsatile CPB demonstrated significantly increased urine flow and reduced postoperative liver enzyme changes, indicating better renal and hepatic function.

    Conclusions:

    • Pulsatile flow during CPB helps maintain hemodynamic stability, particularly by preventing increases in systemic vascular resistance.
    • Pulsatile CPB is associated with improved renal and hepatic function compared to non-pulsatile CPB.
    • The findings suggest pulsatile flow may be advantageous for patient recovery after cardiac surgery.