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Hypertension after coronary operation. Can it be prevented by pulsatile perfusion?
The Journal of Thoracic and Cardiovascular Surgery
|March 1, 1981
Summary
Nonpulsatile perfusion during cardiopulmonary bypass (CPB) may contribute to hypertension. This study found no significant difference in postoperative hypertension rates between pulsatile and nonpulsatile CPB, suggesting current pulsatile methods do not eliminate this risk.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Nephrology
Background:
- Postoperative hypertension is a concern following cardiopulmonary bypass (CPB).
- Nonpulsatile perfusion during CPB is suspected to cause hypertension.
- Renin activity is a potential biomarker for cardiovascular stress.
Purpose of the Study:
- To investigate the impact of pulsatile versus nonpulsatile CPB on postoperative hypertension.
- To compare peripheral renin activity levels between the two perfusion modalities.
Main Methods:
- A consecutive series of coronary bypass patients were assigned to either pulsatile or nonpulsatile CPB.
- Incidence of postoperative hypertension requiring treatment was recorded.
- Peripheral renin activity was measured at multiple time points.
Main Results:
- No significant differences in peripheral renin activity were observed between pulsatile and nonpulsatile CPB groups.
- Hypertension requiring treatment occurred in 60% of patients with pulsatile CPB and 68% with nonpulsatile CPB (p < 0.05).
- The observed difference in hypertension rates did not reach statistical significance.
Conclusions:
- While pulsatile CPB is considered more physiological, this study's method did not eliminate postoperative hypertension.
- Further research is needed to optimize pulsatile CPB techniques to mitigate postoperative hypertension.