The effects of pulsatile and non-pulsatile cardiopulmonary bypass on renal blood flow and function.
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.
Nakamura
K
K
Second Department of Surgery, Miyazaki Medical College, Japan.
Koga
Y
Y
Sekiya
R
R
Onizuka
T
T
Ishii
K
K
Chiyotanda
S
S
Shibata
K
K
D000818:Animals; D002315:Cardiopulmonary Bypass / Q000379:methods*; D004285:Dogs; D006439:Hemodynamics; D007668:Kidney / Q000098:blood supply* / Q000502:physiology; D007773:Lactates / Q000097:blood; D011673:Pulsatile Flow; D011773:Pyruvates / Q000097:blood
D007773:Lactates; D011773:Pyruvates