HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Minami, K. Articles by Korfer, R. Search for Related Content PubMed PubMed Citation Articles by Minami, K. Articles by Korfer, R.

The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 82-91, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Effects of pulsatile perfusion on plasma catecholamine levels and hemodynamics during and after cardiac operations with cardiopulmonary bypass

K Minami, MM Korner, K Vyska, K Kleesiek, H Knobl and R Korfer
Department of Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westphalia, Bad Oeynhausen, Federal Republic of Germany.

Thirty patients scheduled for elective coronary artery bypass grafting were studied in two groups. Group A had standard cardiopulmonary bypass with nonpulsatile perfusion and group B had pulsatile perfusion. Measurements of plasma epinephrine, norepinephrine, granulocyte elastase, and hemodynamic parameters including mean arterial pressure total peripheral resistance, cardiac index, and pulmonary capillary wedge pressure were made before and after anesthesia induction, after surgical incision, during cardiopulmonary bypass, and 2, 4, and 24 hours after the operation. The venous compliance of the total body venous bed was measured at the end of the operation. In all patients the total net fluid balance was determined during bypass and in the postoperative period. In both groups plasma catecholamine levels increased 5 minutes after institution of bypass (epinephrine 176 +/- 56 to 611 +/- 108 pg/ml and norepinephrine 231 +/- 48 to 518 +/- 100 pg/ml in group A; epinephrine 168 +/- 40 to 444 +/- 100 pg/ml and norepinephrine 162 +/- 44 to 267 +/- 52 pg/ml in group B). The maximum catecholamine level was measured between the end of bypass and 2 hours after the end of bypass (epinephrine 1489 +/- 169 pg/ml and norepinephrine 1542 +/- 108 pg/ml in group A; epinephrine 990 +/- 134 pg/ml and norepinephrine 934 +/- 197 pg/ml in group B). During the same period mean arterial pressure and total peripheral resistance were also significantly higher in group A than in group B mean arterial pressure, 61.4 +/- 3 versus 53.6 +/- 3, p less than 0.06; total peripheral resistance, 1055 +/- 60 versus 899 +/- 45, p less than 0.01). The venous compliance was significantly higher in group A than in group B (2.4 +/- 0.3 versus 1.2 +/- 0.3 ml/mm Hg/kg body weight). The intraoperative and perioperative net fluid balance were significantly higher in group A than in group B (p less than 0.005). The average postoperative tracheal intubation time was also significantly longer in group A than in group B (4.6 +/- 1.2 hours versus 2.7 +/- 0.8 hours, p less than 0.001). No significant difference was detected in either hemoglobin or plasma free hemoglobin content between the two groups postoperatively. The results suggest that pulsatile perfusion, when compared with nonpulsatile perfusion, can attenuate the catecholamine stress response to cardiopulmonary bypass, reduce the fluid overloading of patients, and improve the postoperative recovery period as evaluated by tracheal intubation time.

This article has been cited by other articles:

				C. F. Bulcao, P. K. Pandalai, K. M. D'Souza, W. H. Merrill, and S. A. Akhter Uncoupling of Myocardial {beta}-Adrenergic Receptor Signaling During Coronary Artery Bypass Grafting: The Role of GRK2 Ann. Thorac. Surg., October 1, 2008; 86(4): 1189 - 1194. [Abstract] [Full Text] [PDF]

				M. M. Multani, J. S. Ikonomidis, P. Y. Kim, E. A. Miller, K. J. Payne, R. Mukherjee, B. H. Dorman, and F. G. Spinale Dynamic and differential changes in myocardial and plasma endothelin in patients undergoing cardiopulmonary bypass J. Thorac. Cardiovasc. Surg., March 1, 2005; 129(3): 584 - 590. [Abstract] [Full Text] [PDF]

				S. Mussa, T. Prior, N. Alp, K. Wood, K. M. Channon, and D. P. Taggart Duration of action of antispasmodic agents: novel use of a mouse model as an in vivo pharmacological assay Eur. J. Cardiothorac. Surg., November 1, 2004; 26(5): 988 - 994. [Abstract] [Full Text] [PDF]

				T. Velissaris, A. T. M. Tang, M. Murray, R. L. Mehta, P. J. Wood, D. A. Hett, and S. K. Ohri A prospective randomized study to evaluate stress response during beating-heart and conventional coronary revascularization Ann. Thorac. Surg., August 1, 2004; 78(2): 506 - 512. [Abstract] [Full Text] [PDF]

				S. Mussa, T. J. Guzik, E. Black, M. A. Dipp, K. M. Channon, and D. P. Taggart Comparative efficacies and durations of action of phenoxybenzamine, verapamil/nitroglycerin solution, and papaverine as topical antispasmodics for radial artery coronary bypass grafting J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1798 - 1805. [Abstract] [Full Text] [PDF]

				M. F. Newman, T. O. Stanley, and H. P. Grocott Strategies to Protect the Brain During Cardiac Surgery Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 2000; 4(2): 53 - 64. [Abstract] [PDF]

				R Zamparelli, S De Paulis, L Martinelli, M Rossi, A Scapigliati, M Sciarra, F Meo, and R Schiavello Pulsatile normothermic cardiopulmonary bypass and plasma catecholamine levels Perfusion, May 1, 2000; 15(3): 217 - 223. [Abstract] [PDF]

				H. F. Tripp, R. M. Stiegel, and J. P. Coyle The use of pulsatile perfusion during aortic valve replacement in pregnancy Ann. Thorac. Surg., April 1, 1999; 67(4): 1169 - 1171. [Abstract] [Full Text] [PDF]

				E. Silistreli, H. Catalyurek, N. Sariosmanoglu, U. Acikel, E. Hazan, and O. Oto Effects on the Endocrine System of Pulsatile and Nonpulsatile Perfusion in Heart Surgery Asian Cardiovasc Thorac Ann, March 1, 1999; 7(1): 18 - 22. [Abstract] [Full Text] [PDF]

				W. Konertz, H. Hotz, M. Schneider, M. Redlin, and H. Reul Clinical Experience With the MEDOS HIA-VAD System in Infants and Children: A Preliminary Report Ann. Thorac. Surg., April 1, 1997; 63(4): 1138 - 1144. [Abstract] [Full Text]

				K. Toda, E. Tatsumi, Y. Taenaka, T. Masuzawa, and H. Takano Impact of Systemic Depulsation on Tissue Perfusion and Sympathetic Nerve Activity Ann. Thorac. Surg., December 1, 1996; 62(6): 1737 - 1742. [Abstract] [Full Text]

				G. K. Jett ABIOMED BVS 5000: Experience and Potential Advantages Ann. Thorac. Surg., January 1, 1996; 61(1): 301 - 304. [Abstract] [Full Text]

				J. M. Murkin, J. S. Martzke, A. M. Buchan, C. Bentley, and C. J. Wong A RANDOMIZED STUDY OF THE INFLUENCE OF PERFUSION TECHNIQUE AND pH MANAGEMENT STRATEGY IN 316 PATIENTS UNDERGOING CORONARY ARTERY BYPASS SURGERY:I. Mortality and cardiovascular morbidity J. Thorac. Cardiovasc. Surg., August 1, 1995; 110(2): 340 - 348. [Abstract] [Full Text]

				C. Knothe, J. Boldt, B. Zickmann, S. Konstantinov, P. Dick, F. Dapper, and G. Hempelmann Influence of different flow modi during extracorporeal circulation on endothelial-derived vasoactive substances Perfusion, July 1, 1995; 10(4): 229 - 236. [Abstract] [PDF]

				J. Caspi, E. Rudis, I. Bar, T. Safadi, and M. Saute Effects of Magnesium on Myocardial Function After Coronary Artery Bypass Grafting Ann. Thorac. Surg., April 1, 1995; 59(4): 942 - 947. [Abstract] [Full Text]

				R. H. Bartlett Invited letter concerning: Nonpulsatile flow--A noncontroversy J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 644 - 646. [Full Text]

				K. Minami Invited letter concerning: Nonpulsatile flow--A noncontroversy J. Thorac. Cardiovasc. Surg., February 1, 1994; 107(2): 646 - 647. [Full Text]

				H. Komai and S. G Haworth The effect of cardiopulmonary bypass on the lung: the injured pulmonary vascular endothelium Perfusion, January 1, 1993; 8(1): 55 - 62. [PDF]

				T. Thompson, K. Minami, W. Dramburg, K. Vyska, and R. Koerfer The influence of pulsatile and nonpulsatile extracorporeal circulation on fluid retention following coronary artery bypass grafting Perfusion, July 1, 1992; 7(3): 201 - 211. [Abstract] [PDF]