The effects of pulsatile and non-pulsatile cardiopulmonary bypass on renal blood flow and function

• Published in: Japanese journal of surgery 1989-05, Vol.19 (3), p.334-345
• Main Authors: NAKAMURA, K, KOGA, Y, SEKIYA, R, ONIZUKA, T, ISHII, K, CHIYOTANDA, S, SHIBATA, K
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia depending on type of surgery; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Animals; Biological and medical sciences; Cardiopulmonary Bypass - methods; Dogs; Hemodynamics; Kidney - blood supply; Kidney - physiology; Lactates - blood; Medical sciences; Pulsatile Flow; Pyruvates - blood; Thoracic and cardiovascular surgery. Cardiopulmonary bypass
• ISSN: 0047-1909; 1436-2813
• DOI: 10.1007/BF02471410

The physiologic effects of pulsatile and non-pulsatile flow in cardiopulmonary bypass were compared in terms of the relationship between different flow rates and what effects these had on pulsatile and non-pulsatile flow. Forty adult mongrel dogs were used in this study and divided into 5 groups, each comprised of 8 animals, according to the flow rate during cardiopulmonary bypass, namely; 40, 60, 80, 100, or 120 ml/kg/min. The animals were perfused with either pulsatile or non-pulsatile flow for 1 hour, given randomly at the same mean flow rate. At flow rates of 80 and 100 ml/kg/min, the mean arterial blood pressure and total peripheral vascular resistance were significantly lower in pulsatile flow than in non-pulsatile flow, and the renal blood flow was significantly greater in pulsatile flow than in non-pulsatile flow. The renal arterial-venous lactate difference was significantly less in pulsatile flow than in non-pulsatile flow at a flow rate of 80 ml/kg/min, and the renal lactate extraction was significantly higher in pulsatile flow than in non-pulsatile flow at the same flow rate. The renal excess lactate was significantly lower in pulsatile flow than in non-pulsatile flow at a flow rate of 100 ml/kg/min. There were no significant differences in these parameters between the two types of perfusion at flow rates of 40, 60 or 120 ml/kg/min. Pulsatile flow was therefore apparently advantageous, when compared to non-pulsatile flow, in terms of hemodynamics, renal circulation, and metabolism of the kidney at flow rates of 80 and 100 ml/kg/min. However, when the flow rate was 120 ml/kg/min, pulsatile flow and non-pulsatile flow had the same effects.