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The Annals of Thoracic Surgery, Vol 35, 488-492, Copyright © 1983 by The Society of Thoracic Surgeons
MT Nieminen, DM Philbin, CE Rosow, E Lowenstein, A Triantafillou, FH Levine and MJ Buckley
Pulsatile perfusion during cardiopulmonary bypass (CPB) has been reported
to have a number of beneficial effects, including attenuation of hormonal
stress responses and improved organ blood flow and function. To determine
the effect of pulsatile perfusion on temperature gradients and the time
required for cooling and rewarming during CPB, we studied 21 patients
scheduled for elective coronary artery operations. The patients were
divided into two comparable groups: Group 1 (N = 11) had standard
nonpulsatile perfusion, while in Group 2 (N = 10), a pulsatile pump was
used. Rectal and esophageal temperatures were monitored, as were deltoid
muscle temperatures and upper arm and finger skin temperatures in the same
extremity. Ambient temperature, bypass flow and pressure, and bypass time
were similar in both groups. Time required to cool to the lowest esophageal
temperature was virtually identical for both groups (Group 1, 17 +/- 3 min;
Group 2, 17.6 +/- 5 min), as was rewarming time (Group 1, 26.8 +/- 11 min;
Group 2, 27.2 +/- 6 min). There were no significant differences in
temperature measurements between groups except briefly during rewarming
when finger skin temperature rose more rapidly in Group 1 (p less than
0.05). Temperature changes following CPB were the same for both groups,
with rectal and esophageal temperatures showing an inverse relationships.
These data demonstrate that pulsatile flow does not substantially alter
rewarming time or temperature gradients during hypothermic CPB.
ARTICLES
Temperature gradients and rewarming time during hypothermic cardiopulmonary bypass with and without pulsatile flow
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