Document Detail


Clinical effectiveness of centrifugal pump to produce pulsatile flow during cardiopulmonary bypass in patients undergoing cardiac surgery.
MedLine Citation:
PMID:  21314839     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Although the centrifugal pump has been widely used as a nonpulsatile pump for cardiopulmonary bypass (CPB), little is known about its performance as a pulsatile pump for CPB, especially on its efficacy in producing hemodynamic energy and its clinical effectiveness. We performed a study to evaluate whether the Rotaflow centrifugal pump produces effective pulsatile flow during CPB and whether the pulsatile flow in this setting is clinically effective in adult patients undergoing cardiac surgery. Thirty-two patients undergoing CPB for elective coronary artery bypass grafting were randomly allocated to a pulsatile perfusion group (n = 16) or a nonpulsatile perfusion group (n = 16). All patients were perfused with the Rotaflow centrifugal pump. In the pulsatile group, the centrifugal pump was adjusted to the pulsatile mode (60 cycles/min) during aortic cross-clamping, whereas in the nonpulsatile group, the pump was kept in its nonpulsatile mode during the same period of time. Compared with the nonpulsatile group, the pulsatile group had a higher pulse pressure (P < 0.01) and a fraction higher energy equivalent pressure (EEP, P = 0.058). The net gain of pulsatile flow, represented by the surplus hemodynamic energy (SHE), was found much higher in the CPB circuit than in patients (P < 0.01). Clinically, there was no difference between the pulsatile and nonpulsatile groups with regard to postoperative acute kidney injury, endothelial activation, or inflammatory response. Postoperative organ function and the duration of hospital stay were similar in the two patient groups. In conclusion, pulsatile CPB with the Rotaflow centrifugal pump is associated with a small gain of EEP and SHE, which does not seem to be clinically effective in adult cardiac surgical patients.
Authors:
Y John Gu; Willem van Oeveren; Hubert E Mungroop; Anne H Epema; Inez J den Hamer; Jorrit J Keizer; Ron P Leuvenink; Massimo A Mariani; Gerhard Rakhorst
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2011-02-14
Journal Detail:
Title:  Artificial organs     Volume:  35     ISSN:  1525-1594     ISO Abbreviation:  Artif Organs     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-02-17     Completed Date:  2011-05-24     Revised Date:  2011-08-02    
Medline Journal Info:
Nlm Unique ID:  7802778     Medline TA:  Artif Organs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E18-26     Citation Subset:  IM    
Copyright Information:
© 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.
Affiliation:
Department of Biomedical Engineering, University Medical Center Groningen, University of Groningen, The Netherlands. y.j.gu@med.umcg.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiopulmonary Bypass / instrumentation*
Female
Heart-Assist Devices*
Hematologic Tests
Hemodynamics
Humans
Male
Middle Aged
Pulsatile Flow*
Thoracic Surgery / instrumentation*
Comments/Corrections
Comment In:
Artif Organs. 2011 Jun;35(6):672; author reply 673   [PMID:  21623842 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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