title: Stöckert roller pump generated pulsatile flow: cerebral metabolic changes in adult cardiopulmonary bypass.
abstract: There is evidence that during cardiopulmonary bypass (CPB), pulsatile pump flow improves cerebral metabolism. This was a study to explore the effect of pulsatile versus nonpulsatile perfusion on cerebral lactate, pyruvate, glucose and beta-hydroxybutyrate using a Stöckert roller pump. We found no significant differences between the arterial-venous (A-V) differences of lactate, glucose and beta-hydroxybutyrate (p > 0.05). When the upward trend of A-V pyruvate was accounted for, there was again no difference (p = 0.2). Arterial lactate:pyruvate ratios were not significantly different between pulsatile and nonpulsatile pump flow (p > 0.05). Venous lactate:pyruvate ratios were significantly higher during pulsatile bypass, but when the downward trend was accounted for, the differences between pulsatile and nonpulsatile values were no longer significant (p = 0.4). Therefore, the metabolic changes were not significant. There was no significant difference in systemic vascular resistance (SVR) during pulsatile and nonpulsatile flow (p = 0.4). Pulsatile flow delivered by the Stöckert roller pump appears to have no metabolic or SVR advantages in adults undergoing CPB.
authors.affiliation: Department of Neurosciences, Institute of Child Health (UCL)/Great Ormond Street Hospital for Children, London, UK.
authors.forename: G
authors.initials: G
authors.lastname: Chow
authors.forename: I G
authors.initials: IG
authors.lastname: Roberts
authors.forename: D
authors.initials: D
authors.lastname: Harris
authors.forename: J
authors.initials: J
authors.lastname: Wilson
authors.forename: M J
authors.initials: MJ
authors.lastname: Elliott
authors.forename: A D
authors.initials: AD
authors.lastname: Edwards
authors.forename: F J
authors.initials: FJ
authors.lastname: Kirkham
mesh_terms: D020155:3-Hydroxybutyric Acid; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001921:Brain / Q000378:metabolism*; D001923:Brain Chemistry; D002315:Cardiopulmonary Bypass / Q000009:adverse effects* / Q000295:instrumentation*; D002560:Cerebrovascular Circulation; D001026:Coronary Artery Bypass; D004867:Equipment Design; D006801:Humans; D006885:Hydroxybutyrates / Q000097:blood; D019344:Lactic Acid / Q000097:blood; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow; D019289:Pyruvic Acid / Q000097:blood; D014655:Vascular Resistance
chemical_list: D001786:Blood Glucose; D006885:Hydroxybutyrates; D019344:Lactic Acid; D019289:Pyruvic Acid; D020155:3-Hydroxybutyric Acid