Systolic pressure measurement in the ascending aorta: augmentation at the aortic cannula sideport.
To assess whether arterial blood pressure measured at the sideport of the aortic cannula mirrors that measured within the ascending aorta, the two pressures were compared in 10 consecutive patients undergoing cardiopulmonary bypass. The mean arterial pressures (MAP) were equal both before and after bypass, but the sideport systolic arterial pressure (SAP) was 6.0 +/- 0.8 mm Hg higher than the aortic SAP before bypass and 9.1 +/- 0.5 mm Hg higher than the aortic SAP after bypass (P less than 0.001). Hematocrit, blood temperature, cardiac output, and heart rate did not correlate with the differences in SAP, suggesting that the higher SAP seen at the sideport was generated within the tube connecting the oxygenator to the aorta. This theory was investigated by decreasing the tube length distal to the sideport in three patients in this group who had sideport SAPs higher than their aortic SAPs, a measure that decreased the SAP difference between the two sites. At the end of cardiopulmonary bypass in 20 other consecutive patients, the effect of shortening the aorta-oxygenator tube from 1.8 to 0.25 m was tested. The SAP in the sideport decreased by 4 to 12 mm Hg in 12 of the 20 patients, while the MAP was unaffected by this maneuver. It is concluded that the MAP measured at the sideport of the aortic cannula closely reflects the MAP in the ascending aorta, whereas the SAP measured at the sideport does not reflect the aortic SAP. Thus, when aortic pressure is measured at the sideport to confirm an artificially low radial arterial pressure, systolic amplification at the sideport might simulate or exaggerate radial artery hypotension.
Pauca
A L
AL
Department of Anesthesia, Wake Forest University Medical Center, Winston-Salem, NC.
Hudspeth
A S
AS
Wallenhaupt
S L
SL
Kon
N D
ND
Cordell
A R
AR
D001011:Aorta / Q000502:physiology*; D001794:Blood Pressure / Q000502:physiology*; D015924:Blood Pressure Monitors; D002315:Cardiopulmonary Bypass / Q000295:instrumentation; D002404:Catheterization / Q000295:instrumentation*; D003971:Diastole / Q000502:physiology; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010106:Oxygenators; D013599:Systole / Q000502:physiology*; D014160:Transducers, Pressure