The pulsatile perfusion debate in cardiac surgery: Answers from the microcirculation?

Journal of Cardiothoracic and Vascular Anesthesia

Volumn 29, Issue 3, 2015, Pages 761-767

  Hoefeijzers, Marjolein P ^a   Ter Horst, Leontien H ^a   Koning, Nick ^a   Vonk, Alexander B ^b   Boer, Christa ^a   Elbers, Paul W G ^a  

^a VU UNIVERSITY MEDICAL CENTER   (Netherlands)

^b VU UNIVERSITY MEDICAL CENTER   (Netherlands)

Author keywords

cardiac surgery; cardiopulmonary bypass; microcirculation; orthogonal polarization spectral (OPS) imaging; pulsatile perfusion; side stream dark field (SDF) imaging

Indexed keywords

HEMOGLOBIN; LACTIC ACID;

BRAIN MICROCIRCULATION; CARDIOPULMONARY BYPASS; CARDIOVASCULAR MORTALITY; CLINICAL PRACTICE; EXTERNAL VALIDITY; HEART INDEX; HEART PERFUSION; HEART SURGERY; HEMOGLOBIN BLOOD LEVEL; HIGH RISK PATIENT; HUMAN; LACTATE BLOOD LEVEL; LENGTH OF STAY; LEUKOCYTE ADHERENCE; MEAN ARTERIAL PRESSURE; NONHUMAN; OXYGEN CONSUMPTION; PATIENT RISK; PRIORITY JOURNAL; PULSATILE PERFUSION; PULSE PRESSURE; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SURGICAL MORTALITY; TONOMETRY; TREATMENT DURATION; VASCULAR RESISTANCE; ANIMAL; META ANALYSIS; MICROCIRCULATION; PHYSIOLOGY; PIG; PROCEDURES; PULSATILE FLOW; THORAX SURGERY; TRENDS;

ANIMALS; CARDIAC SURGICAL PROCEDURES; HUMANS; MICROCIRCULATION; PULSATILE FLOW; SWINE; THORACIC SURGERY;

EID: 84930086603     PISSN: 10530770     EISSN: 15328422     Source Type: Journal    
DOI: 10.1053/j.jvca.2014.07.025     Document Type: Review

References (34)

1. G.S. Murphy, E.A. Hessel 2nd, and R.C. Groom Optimal perfusion during cardiopulmonary bypass: An evidence-based approach Anesth Analg 108 2009 1394 1417
2. J.M. Murkin, J.S. Martzke, and A.M. Buchan A randomized study of the influence of perfusion technique and pH management strategy in 316 patients undergoing coronary artery bypass surgery. I. Mortality and cardiovascular morbidity J Thorac Cardiovasc Surg 110 1995 340 348
3. A.A. Alghamdi, and D.A. Latter Pulsatile versus nonpulsatile cardiopulmonary bypass flow: An evidence-based approach J Card Surg 21 2006 347 354
4. P. Hornick, and K. Taylor Pulsatile and nonpulsatile perfusion: The continuing controversy J Cardiothorac Vasc Anesth 11 1997 310 315
5. S. Wang, N. Haines, and A. Undar Quantification of pressure-flow waveforms and selection of components for the pulsatile extracorporeal circuit J Extra Corpor Technol 41 2009 P20 P25
6. R.B. Shepard, D.C. Simpson, and J.F. Sharp Energy equivalent pressure Arch Surg 93 1966 730 740
7. B. Ji, and A. Undar An evaluation of the benefits of pulsatile versus nonpulsatile perfusion during cardiopulmonary bypass procedures in pediatric and adult cardiac patients ASAIO J 52 2006 357 361
8. N.J. Koning, B. Atasever, and A.B. Vonk Changes in microcirculatory perfusion and oxygenation during cardiac surgery with or without cardiopulmonary bypass J Cardiothorac Vasc Anesth Sept 2013 16 [Epub ahead of print]
9. E. Lanzarone, F. Gelmini, and A. Fumero Preservation of endothelium nitric oxide release during beating heart surgery with respect to continuous flow cardiopulmonary bypass Perfusion 25 2010 57 64
10. T. Nakano, R. Tominaga, and I. Nagano Pulsatile flow enhances endothelium-derived nitric oxide release in the peripheral vasculature Am J Physiol Heart Circ Physiol 278 2000 1098 1104
11. P.W. Elbers, and C. Ince Mechanisms of critical illness - Classifying microcirculatory flow abnormalities in distributive shock Crit Care 10 2006 221
12. P.W. Elbers Fast-track microcirculation analysis Crit Care 11 2007 426
13. P.W. Elbers, A. Ozdemir, and M. van Iterson Microcirculatory imaging in cardiac anesthesia: Ketanserin reduces blood pressure but not perfused capillary density J Cardiothorac Vasc Anesth 23 2009 95 101
14. P.W. Elbers, W.B. Prins, and H.W. Plokker Electrical cardioversion for atrial fibrillation improves microvascular flow independent of blood pressure changes J Cardiothorac Vasc Anesth 26 2012 799 803
15. L.D. Munsterman, P.W. Elbers, and A. Ozdemir Withdrawing intra-aortic balloon pump support paradoxically improves microvascular flow Crit Care 14 2010 R161
16. A.R. Jadad, R.A. Moore, and D. Carroll Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Control Clin Trials 17 1996 1 12
17. M.P. O'Neil, J.C. Fleming, and A. Badhwar Pulsatile versus nonpulsatile flow during cardiopulmonary bypass: Microcirculatory and systemic effects Ann Thorac Surg 94 2012 2046 2053
18. N.J. Koning, A.B. Vonk, and L.J. van Barneveld Pulsatile flow during cardiopulmonary bypass preserves postoperative microcirculatory perfusion irrespective of systemic hemodynamics J Appl Physiol (1985) 112 2012 1727 1734
19. P.W. Elbers, J. Wijbenga, and F. Solinger Direct observation of the human microcirculation during cardiopulmonary bypass: Effects of pulsatile perfusion J Cardiothorac Vasc Anesth 25 2011 250 255
20. G. Grubhofer, P. Mares, and A. Rajek Pulsatility does not change cerebral oxygenation during cardiopulmonary bypass Acta Anaesthesiol Scand 44 2000 586 591
21. S.K. Ohri, C.W. Bowles, and R.T. Mathie Effect of cardiopulmonary bypass perfusion protocols on gut tissue oxygenation and blood flow Ann Thorac Surg 64 1997 163 170
22. B. Voss, M. Krane, and C. Jung Cardiopulmonary bypass with physiological flow and pressure curves Pulse is unnecessary! Eur J Cardiothorac Surg 37 2010 223 232
23. M. Noris, M. Morigi, and R. Donadelli Nitric oxide synthesis by cultured endothelial cells is modulated by flow conditions Circ Res 76 1995 536 543
24. Y. Ohnishi, Q.H. Hu, and S. Yamaguchi Cerebral microcirculatory changes in rat with a cardiopulmonary bypass using fluorescence videomicroscopy Clin Hemorheol Microcirc 26 2002 15 26
25. J.J. Lee, K. Tyml, and A.H. Menkis Evaluation of pulsatile and nonpulsatile flow in capillaries of goat skeletal muscle using intravital microscopy Microvasc Res 48 1994 316 327
26. Y.J. Kang, M.G. Kim, and K.H. Son Experimental investigation of pulsatility effect on the deformability and hemolysis of blood cells Art Org 34 2010 E103 E109
27. M. Dodonov, A. Milano, and F. Onorati Gaseous micro-emboli activity during cardiopulmonary bypass in adults: Pulsatile flow versus nonpulsatile flow Art Org 37 2013 357 367
28. A.D. Milano, M. Dodonov, and F. Onorati Pulsatile flow decreases gaseous micro-bubble filtering properties of oxygenators without integrated filters during cardiopulmonary bypass Interact Cardiovasc Thorac Surg 17 2013 811 817
29. F. Onorati, A. Esposito, and M.C. Comi Intra-aortic balloon pump-induced pulsatile flow reduces coagulative and fibrinolytic response to cardiopulmonary bypass Artif Organs 32 2008 433 441
30. F. Onorati, P. Presta, and G. Fuiano A randomized trial of pulsatile perfusion using an intra-aortic balloon pump versus nonpulsatile perfusion on short-term changes in kidney function during cardiopulmonary bypass during myocardial reperfusion Am J Kidney Dis 50 2007 229 238
31. F. Oronati, L. Cristodoro, and P. Mastroroberto Should we discontinue intraaortic balloon during cardioplegic arrest? Splanchnic function results of a prospective randomized trial Ann Thorac Surg 80 2005 2221 2228
32. M.S. Slaughter, J.G. Rogers, and M.D. Carmelo Advanced heart failure treated with continuous-flow left ventricular assist device N Engl J Med 361 2009 2241 2251
33. P.E. Marik Sublingual capnography: A clinical validation study Chest 120 2001 923 927
34. C.L. Verdant, D. De Backer, and A. Bruhn Evaluation of sublingual and gut mucosal microcirculation in sepsis: A quantitative analysis Crit Care Med 37 2009 2875 2881