Hemodynamic analysis could resolve the pulsatile blood flow controversy

Wright, G.

doi:10.1016/0003-4975(94)90498-7

Cited by 92 publications

(68 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Pearson's 2 and Fischer's exact 2 tests were used to analyze the distribution of risk factors in subgroups. The Mann-Whitney U test was used to analyze differences in group means for risk factors.…”

Section: Resultsmentioning

confidence: 99%

“…Patients with chronic renal failure and chronic obstructive pulmonary disease have an increased risk of fatal outcome, increased length of hospital stay and increased incidence of organ failure and morbidity after open heart surgery [1][2][3] . Although non-pulsatile cardiopulmonary bypass is used more expansively than pulsatile cardiopulmonary bypass, it causes transient dysfunction of many systems (especially renal and pulmonary).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pulsatile Flow Improves Renal Function in High-Risk Cardiac Operations

Kocakulak

Aşkın²,

Küçükaksu³

et al. 2005

Blood Purif

View full text Add to dashboard Cite

The effects of pulsatile perfusion on microcirculation and renal function in high-risk patients were evaluated in this study. Pulsatile roller pumps with a pulsatile control module and membrane oxygenator were used in a clinical setting. 40 patients undergoing elective cardiac surgery with a high risk of either having chronically obstructive pulmonary disease or chronic renal failure were randomly included in the study to be perfused using pulsatile or continuous flows. Blood samples were collected at induction of anesthesia, at the time of aortic clamping and declamping and 1 and 24 h following cessation of the bypass. Urea and creatinine concentrations in blood were measured and systemic vascular resistance was calculated. Urine output, crystalloid and colloid infusions were recorded. We observed that pulsatile roller pump perfusion and the extracorporeal circuit used in the clinical study improved microcirculation and renal function in high-risk patients undergoing cardiopulmonary bypass.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pulsatile Flow Improves Renal Function in High-Risk Cardiac Operations

Kocakulak

Aşkın²,

Küçükaksu³

et al. 2005

Blood Purif

View full text Add to dashboard Cite

show abstract

“…The perfusion mode (pulsatile vs non-pulsatile) may play an important role in this process. However, more than half a century after the clinical introduction of ECC, data whether pulsatile perfusion is superior to non-pulsatile perfusion are still controversial [3,4]. In the early 1950s, pulsatile pumps were used in experimental setups for animal perfusion.…”

Section: Introductionmentioning

confidence: 99%

Cardiopulmonary bypass with physiological flow and pressure curves: pulse is unnecessary!☆

Voß

Krane

Jung

et al. 2010

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

show abstract

“…Thus, the modified roller pump is not able to produce an adequately high amplitude flow in the major circulation. Several studies which intended to elucidate the advantages of pulsatile power have mainly failed because of the inadequate pulsatile power used [17]. For a low pressure system such as the pulmonary vasculature, however, such a modified roller pump may well be able to deliver adequate physiological pulsatile flow to the pulmonary artery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Pulsatile and Nonpulsatile Perfusion of the Lung in an Extracorporeal Large Animal Model

Brandes

Albes²,

Conzelmann³

et al. 2002

Eur Surg Res

View full text Add to dashboard Cite

Objective: Extracorporeal lung-perfusion models are widely used to evaluate pulmonary preservation techniques and reperfusion injury. However, these models mainly depend on nonpulsatile flow, which is not physiological and can subsequently lead to pulmonary edema. Observation in a standardized setting and reliability of functional and structural data assessment are therefore limited. To overcome these limitations we developed a new extracorporeal large animal lung perfusion model utilizing pulsatile flow to perfuse the pulmonary vasculature. Methods: Lungs of juvenile domestic pigs were in situ preserved with 2 liters Perfadex^® and stored for 3 h at 10°C. Thereafter, reperfusion of the lung was performed in an extracorporeal blood perfusion circuit employing either a modified roller pump with pulsatile module (300 ml/min; pulsation rate 90/min) or a standardized roller pump with continuous flow (30 ml/min). Ventilation was performed with physiologic room air (350 ml; 16/min) for 1 h. Pulsatile and nonpulsatile perfusion was performed in 2 groups (group NP: nonpulsatile; group P: pulsatile flow, n = 7) during reperfusion. Peak inspiratory pressure (PIP), mean pulmonary artery pressure (PAP), and oxygenation capacity (ΔPO₂) were continuously measured. For control of the effectiveness of the pulsatile perfusion pressure waveforms were obtained directly from the native pulmonary artery of both groups. Malondialdehyde (MDA) as a parameter for lipid peroxidation and endothelial cell damage was assessed at 10, 30 and 50 min reperfusion. At the end of the study, pulmonary water content was assessed by means of wet-to-dry ratio (W/D ratio). The tissue was further processed for microscopic analysis. Results: PIP increased significantly in both groups during reperfusion. Mean PAP in both groups increased to 60 mm Hg after 20 min followed by a decrease after 60 min to 40 mm Hg. Pressure waveforms of the pulmonary artery showed sufficient pulsatility in the pulmonary vasculature with a systolic/diastolic pressure difference of 15 mm Hg whereas the pressure difference was 3–5 mm Hg in the nonpulsatile group. ΔPO₂ was stable in groups NP and P during reperfusion (30 min: NP: 66.4 (62.2–88) mm Hg; P: 74.8 (65–81.7) mm Hg) without any statistically significant differences between the groups. MDA in group NP decreased over the reperfusion period from 6.2 (3.3–6.3) µM at 10 min to 5.2 (3.2–6.1) µM at 50 min, whereas in group P the level increased and was significantly higher after 50 min reperfusion compared to group NP [6.6 (6.1–9.2) µM at 50 min; p = 0.016]. W/D ratio was 6.7 (6.3–7.0) in group NP and 6.8 (6.3–7.6) in group P. Light microscopy evaluation showed no differences between both groups regarding severity of intra-alveolar and interstitial edema and numbers of intra-alveolar, intracapillary and interstitial granulocytes. Conclusion: Although effective pulsatile perfusion of the pulmonary vasculature was achieved by means of a modified roller pump, this measure obviously did not improve fu...

show abstract

Hemodynamic analysis could resolve the pulsatile blood flow controversy

Cited by 92 publications

References 35 publications

Pulsatile Flow Improves Renal Function in High-Risk Cardiac Operations

Pulsatile Flow Improves Renal Function in High-Risk Cardiac Operations

Cardiopulmonary bypass with physiological flow and pressure curves: pulse is unnecessary!☆

Comparison of Pulsatile and Nonpulsatile Perfusion of the Lung in an Extracorporeal Large Animal Model

Contact Info

Product

Resources

About