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Cardiopulmonary bypass and forearm blood flow
A L Pauca1, S L Wallenhaupt, N D Kon
1Department of Anesthesia, Bowman Gray School of Medicine, Winston-Salem, NC 27157-1009.
Chest
|November 1, 1994
Summary
Cardiopulmonary bypass (CPB) temporarily lowers muscle blood flow (MBF). Blood flow recovers to normal levels during and after CPB, suggesting it
Area of Science:
- Cardiovascular Surgery
- Physiology
- Vascular Biology
Background:
- Cardiopulmonary bypass (CPB) is a critical procedure in cardiac surgery.
- The impact of CPB on muscle blood flow (MBF) requires further elucidation.
- Forearm blood flow (FBF) is a common surrogate for systemic MBF.
Purpose of the Study:
- To evaluate the effect of CPB on forearm muscle blood flow (MBF).
- To assess changes in forearm vascular resistance (FVR) during CPB.
- To identify factors influencing MBF and FVR during cardiac surgery.
Main Methods:
- Prospective study involving 27 patients undergoing coronary bypass grafting.
- Forearm blood flow (FBF) measured using venous occlusion plethysmography.
- Measurements taken before, during (cold and warm), and after CPB.
Main Results:
- Baseline FBF was approximately 50% lower than normal, with higher FVR.
- FBF significantly increased (p < 0.001) during and after CPB.
- FVR significantly decreased (p < 0.001) throughout CPB.
- Only mean arterial pressure (MAP) showed a statistically significant effect on FVR (p = 0.042).
Conclusions:
- The observed increase in MBF during and after CPB represents a return to normal levels.
- The precise role of this MBF recovery in the low systemic vascular resistance (SVR) during CPB remains unclear.