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Ann Thorac Surg 1997;63:1243-1250
© 1997 The Society of Thoracic Surgeons

Original Article: Cardiovascular

Regional Blood Flow During Pulsatile Cardiopulmonary Bypass and After Circulatory Arrest in an Infant Model

Andrew J. Lodge, MD, Akif Ündar, PhD, C. William Daggett, MD, Thomas M. Runge, MD, John H. Calhoon, MD, Ross M. Ungerleider, MD

Division of Cardiothoracic Surgery, Duke University Medical Center, Durham, North Carolina; Biomedical Engineering Program, University of Texas, Austin, Texas; and Division of Cardiothoracic Surgery, University of Texas Health Science Center, San Antonio, Texas

Background. Pulsatile perfusion systems have been proposed as a means of improving end-organ perfusion during and after cardiopulmonary bypass. Few attempts have been made to study this issue in an infant model.

Methods. Neonatal piglets were subjected to nonpulsatile (n = 6) or pulsatile (n = 7) cardiopulmonary bypass and 60 minutes of circulatory arrest. Cerebral, renal, and myocardial blood flow measurements were obtained at baseline, on bypass before and after circulatory arrest, and after bypass.

Results. Cerebral blood flow did not differ between groups at any time and was diminished equally in both groups after circulatory arrest. Renal blood flow was diminished in both groups during bypass but was significantly better in the pulsatile group than in the nonpulsatile group prior to, but not after, circulatory arrest. Myocardial blood flow was maintained at or above baseline in the pulsatile group throughout the study, but in the nonpulsatile group, it was significantly lower than baseline during CPB prior to circulatory arrest and lower compared with baseline and with the pulsatile group 60 minutes after CPB.

Conclusions. Pulsatile bypass does not improve recovery of cerebral blood flow after circulatory arrest, may improve renal perfusion during bypass but does not improve its recovery after ischemia, and may have beneficial effects on myocardial blood flow during bypass and after ischemia compared with nonpulsatile bypass in this infant model.


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Discussion
Ann. Thorac. Surg. 1997 63: 1250. [Extract] [Full Text]



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