Authors:
Publish Date: 1991/01/01
Volume: 5, Issue: 1, Pages: 22-26
Abstract
Several efforts have been made to improve the technique ofcardiopulmonary bypass CPB including the use of pulsatile flow and themodification of cannulation technique The present study focused uponextravascular lung water EVLW in 60 aortocoronary bypass patientssubjected to four different perfusion techniques during CPB group 1 n =15 nonpulsatile flow and standard cannulation group 2 n = 15pulsatile flow and standard cannulation group 3 n = 15 nonpulsatileflow and monoatrial cannulation ie always partial bypass during CPBgroup 4 n = 15 pulsatile flow and monoatrial cannulation EVLW contentwas measured using the doubleindicator dilution technique with indocyaninegreen in addition various hemodynamic and laboratory variables weremeasured Lung water content rose above normal values mean 579 +/ 033ml/kg only in the groups submitted to the standard cannulation techniqueirrespective of whether the perfusion flow was pulsatile or not group 1 +274 group 2 + 255 Pulmonary gas exchange too was compromised onlyin these patients PaO2 in group 1 19 and in group 2 17 Qs/Qt in group1 + 36 rel and in group 2 + 29 rel whereas all patients withmonoatrial cannulation and partial bypass throughout the CPB period showedno rise in EVLW content or Qs/Qt and no drop in PaO2 From the results ofthis study we conclude that pulsatile perfusion during open heart surgicalprocedure has no advantages in regard to lung water content Monoatrialcannulation with partial bypass at all times during CPB however seems tobe beneficial probably owing to the maintenance of pulmonary circulationduring the bypass period
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