Document Detail

Central-to-peripheral arterial pressure gradient during cardiopulmonary bypass: relation to pre- and intra-operative data and effects of vasoactive agents.
MedLine Citation:
PMID:  7941944     Owner:  NLM     Status:  MEDLINE    
A significant central-to-peripheral arterial pressure gradient may exist during and after cardiopulmonary bypass (CPB). The etiology and mechanisms of this phenomenon remain controversial. We studied the pressure gradient between aorta, brachial artery and radial artery in 68 patients, scheduled for elective coronary artery bypass surgery. We evaluated whether choice of cardioprotection during CPB (use of cold cardioplegic solution or use of intermittent crossclamping under protection with lidoflazine), and choice of pulsatile or nonpulsatile flow during the course of CPB, affected the magnitude and duration of the systolic pressure gradient. We also studied whether central-to-peripheral pressure gradient was influenced by administration on CPB of different vasoactive drugs with different mode of action: sodium nitroprusside (direct action on the vessels), droperidol (alpha-adrenergic blocking action), ketanserin (5-hydroxytryptamine antagonist) and phenylephrine (selective alpha 1-agonist). It appeared that central-to-peripheral gradient occurred early during CPB and remained constant throughout the course of CPB. The gradient disappeared within 60 min after weaning from CPB. We found the main pressure gradient to occur between the brachial and the radial artery. There was no relation between magnitude of the gradient and sex, weight, length or age of the patient. There was also no relation between magnitude of the pressure gradient and type of cardioprotection, choice of pulsatile vs nonpulsatile flow on CPB and duration of CPB. We also found no relation between pressure gradients and changes in temperature, haematocrit and systemic vascular resistance. The pressure gradient was not affected by any of the vasoactive drugs.
S G De Hert; K M Vermeyen; M M Moens; V L Hoffmann; K J Bataillie
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  38     ISSN:  0001-5172     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  1994 Jul 
Date Detail:
Created Date:  1994-11-14     Completed Date:  1994-11-14     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  479-85     Citation Subset:  IM    
Department of Anesthesia, University Hospital Antwerp, Edegem, Belgium.
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MeSH Terms
Aorta / physiology
Blood Physiological Phenomena
Blood Pressure / drug effects,  physiology*
Body Temperature
Brachial Artery / physiology
Cardioplegic Solutions / administration & dosage
Cardiopulmonary Bypass / methods*
Droperidol / pharmacology
Intraoperative Care
Ketanserin / pharmacology
Lidoflazine / administration & dosage
Middle Aged
Nitroprusside / pharmacology
Phenylephrine / pharmacology
Preoperative Care
Pulsatile Flow
Radial Artery / physiology
Vasoconstrictor Agents / pharmacology*
Vasodilator Agents / pharmacology*
Reg. No./Substance:
0/Cardioplegic Solutions; 0/Vasoconstrictor Agents; 0/Vasodilator Agents; 15078-28-1/Nitroprusside; 3416-26-0/Lidoflazine; 548-73-2/Droperidol; 59-42-7/Phenylephrine; 74050-98-9/Ketanserin

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