title: [Clinical application of a supplement to the extracorporal circulation to produce a pulsatile flow (author's transl)].
abstract: Two groups of patients with atherosclerotic coronary artery disease, who underwent aortocoronary bypass operation, were perfused with nonpulsatile flow during extracorporeal circulation (ECC) using membrane oxygenators. One group (MO) was used as a control, while for the other group (PAD) a Pulsatile Assist Device in the arterial line was employed. This apparatus consists of a balloon of 80 ml placed inside a rigid housing. The balloon is compressed by pressurized air or expanded by vacuum supplied by a driving console. The apparatus produced pulse amplitudes between 30 and 50 mm of mercury. Other than a very short-lasting fall in mean arterial pressure, thus showing diminished peripheral resistance, no perceptable advantages were found. Base excess and pH-changes showed no differences, also the given amount of sodium bicarbonate in both groups was the same. On the other hand significantly higher hemolyses took place, increasing with the duration of pulsation. The application of the apparatus as an arterial counterpulsator was possible with limitation in only 5 of 15 patients. In all other patients after a short time massive blood foaming developed in the PAD and the attempts had to be stopped because of the risk of gas embolism. In our opinion this apparatus is an unnecessary supplement to the ECC and as an arterial counterpulsator it seems too dangerous.
mesh_terms: D000328:Adult; D000368:Aged; D001158:Arteries; D001784:Blood Gas Analysis; D001794:Blood Pressure; D002986:Clinical Trials as Topic; D001026:Coronary Artery Bypass / Q000295:instrumentation; D006355:Heart-Lung Machine / Q000295:instrumentation*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008875:Middle Aged; D010107:Oxygenators, Membrane; D010313:Partial Pressure; D010477:Perfusion / Q000379:methods; D011674:Pulse; D013997:Time Factors
chemical_list: D006454:Hemoglobins
vernacular_title: Klinische Verwendung eines Zusatzgerätes zur Herz-Lungen-Maschine zur Erzeugung eines pulsierenden Blutflusses.