Effect of priming volume on serum catecholamines during cardiopulmonary bypass

Several theories have been proposed to explain the transient hypotension which occurs upon the initiation of cardiopulmonary bypass. The present study investigated the possibility that addition of the lactated Ringer's solution pump priming volume to the circulation causes dilution of circulating catecholamines leading to the hypotension. Circulating epinephrine and norepinephrine levels were measured during cardiopulmonary bypass in patients anaesthetized with halothane. The results demonstrate dilution of circulating catecholamines at the start of bypass in conjunction with the observed hypotension. During the bypass period, mean blood pressure graudally recovered to normotensive levels even though circulating catecholamine levels remained significantly lowered, indicating a mechanism for the recovery of blood press which is not sympathoadrenal. The results obtained from this study demonstrate a temporal relationship between catecholamine dilution by the pump priming volume and the observed hypotension. Whether catecholamine dilution is the sole factor causing the hypotension remains to be determined.