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J Thorac Cardiovasc Surg 1996;111:478-484
© 1996 Mosby, Inc.

CARDIOPULMONARY BYPASS,
MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

THE EFFECTS OF PULSATILE AND NONPULSATILE SYSTEMIC PERFUSION ON RENAL SYMPATHETIC NERVE ACTIVITY IN ANESTHETIZED DOGS

Kouji Fukae, MDa, Ryuji Tominaga, MDa, Shigehiko Tokunaga, MDa, Yoshito Kawachi, MDa, Tsutomu Imaizumi, MDb, Hisataka Yasui, MDa


Fukuoka, Japan

Received for publication April 4, 1995. Accepted for publication August 30, 1995. Address for reprints: Kouji Fukae, MD, Division of Cardiovascular Surgery, Research Institute of Angiocardiology, Faculty of Medicine, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-82 Japan.

Abstract

It is still controversial whether to pulse or not to pulse for the establishment of ideal extracorporeal circulation. We directly measured the renal sympathetic nerve activity in mongrel dogs (n = 10, weighing from 13 to 21 kg) to determine the effects of pulsatile and nonpulsatile systemic perfusion on the control of the sympathetic nerve activity during left ventricular assistance. Pulsatile perfusion was generated with an air-driven, diaphragm-type blood pump, and nonpulsatile perfusion was generated with a centrifugal pump. Renal sympathetic nerve activity and the blood flow of the descending aorta were then recorded during pulsatile and nonpulsatile systemic perfusion. Other variables, such as mean arterial pressure, central venous pressure, left atrial pressure, and blood gas levels, were kept constant. At the same mean arterial pressure, renal sympathetic nerve activity during pulsatile perfusion decreased significantly to 80% of renal sympathetic nerve activity during nonpulsatile perfusion (26.8 ± 2.4 vs 33.4 ± 2.9 spikes/sec, p < 0.01). Total systemic vascular resistance during pulsatile perfusion decreased significantly to 85% of that during nonpulsatile perfusion (5700 ± 580 vs 6667 ± 709 dynes · sec · cm-5, p < 0.05). These results suggest that pulsatile systemic perfusion, compared with nonpulsatile systemic perfusion, reduces sympathetic nerve activity and peripheral vascular resistance and thus may improve both microcirculation and organ function. (J THORAC CARDIOVASC SURG 1996;111:478-84)




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