Logo Medical Science Monitor Basic Research

Call: 1.631.470.9640
Mon-Fri 10 am - 2 pm EST

Contact Us

Logo Medical Science Monitor Basic Research Logo Medical Science Monitor Basic Research Logo Medical Science Monitor Basic Research

21 October 2002

Pulsatile extracorporeal circulation--let it be?

Calvin S.H. Ng, Song Wan, Anthony Yim

Med Sci Monit 2002; 8(10): ED17-19 :: ID: 4863

Abstract

Cardiopulmonary bypass (CPB) is known to induce a whole body inflammatory response. Since the 1970's, a number of trials have explored the effects of pulsatile CPB on systemic organ function and inflammatory response. Clinical benefits of neuroprotection, improved myocardial and splanchnic perfusion, as well as attenuated systemic inflammatory response have been reported. However, skepticism for pulsatile CPB remains because of inconsistencies of clinical benefits and 'non-standardized' trials. Tarcan and colleagues compared clinical, haemodynamic, biochemical and haematological parameters in patients with chronic obstructive pulmonary disease undergoing CPB with pulsatile flow versus those without. They found higher circulating white cell count and lower neutrophil count at 1 hour post-operatively in the pulsatile group compared with non-pulsatile group, which was attributed to higher pulmonary neutrophil sequestration. In addition, the pulsatile CPB group had lower pulmonary vascular resistance at 1 hour post-operatively and shorter ventilation time. In the current study, confirmation for pulmonary neutrophil sequestration in the form of bronchoalveolar lavage (BAL) or histology would have been welcomed, and additional markers such as neutrophil elastase or matrix metello-proteinases in BAL, and other measurements of lung function may help clarify the association between neutrophil sequestration, lung injury and clinical endpoints. The role of pulsatile CPB in certain high-risk patients remain uncertain, and until more definite evidence of benefit is available, we should be cautious of its universal application.

Keywords: Cardiopulmonary Bypass - methods, Extracorporeal Circulation - methods, Hemodynamic Processes, Pulmonary Disease, Chronic Obstructive - therapy, Pulsatile Flow

0 Comments

Most Viewed Current Articles

13 Apr 2020 : Original article  

Outcome of 24 Weeks of Combined Schroth and Pilates Exercises on Cobb Angle, Angle of Trunk Rotation, Chest...

DOI :10.12659/MSMBR.920449

Med Sci Monit Basic Res 2020; 26:e920449

11 May 2020 : Original article  

Analysis of Psychological and Sleep Status and Exercise Rehabilitation of Front-Line Clinical Staff in the ...

DOI :10.12659/MSMBR.924085

Med Sci Monit Basic Res 2020; 26:e924085

05 Jan 2021 : Review article  

A Southeast Asian Perspective on the COVID-19 Pandemic: Hemoglobin E (HbE)-Trait Confers Resistance Against...

DOI :10.12659/MSMBR.929207

Med Sci Monit Basic Res 2021; 27:e929207

10 Aug 2020 : Clinical Research  

Effects of Cognitive Task Training on Dynamic Balance and Gait of Patients with Stroke: A Preliminary Rando...

DOI :10.12659/MSMBR.925264

Med Sci Monit Basic Res 2020; 26:e925264

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Medical Science Monitor Basic Research eISSN: 2325-4416
Medical Science Monitor Basic Research eISSN: 2325-4416