Clinical evaluation of pulsatile flow by pulsatile bypass pump for deep hypothermia and circulatory arrest in infants
Yasui, H.; Komori, M.; Sese, A.; Kado, H.; Tanaka, J.; Matsui, K.; Tominaga, R.; Yoshitoshi, M.; Tokunaga, K.
Nihon Kyobu Geka Gakkai 30(12): 1916-1923
1982
ISSN/ISBN: 0369-4739 PMID: 7169557 Document Number: 185895
To improve the result of infants' open heart surgery, pulsatile bypass pumping (PBP) was employed in 10 infants undergoing deep hypothermia and circulatory arrest. Based on an animal experiment, the size of arterial cannula was determined, a Bardic # 10 cannula at body wt < 3 kg, # 12 at 3-6 kg, # 14 at 6-9 kg and # 16 at 9-12 kg. The driving pressure and pumping rate of PBP were 350 mm Hg and 100 b.p.m. of 900 .+-. 400 mm Hg/s was obtained during both core cooling and rewarming period. Clinical results of those patients with PBP were compared with those of 10 patients with nonpulsatile flow perfusion in the same deep hypothermia and circulatory arrest. Temperature differences between esophagus and rectum, plantar arch of infants receiving pulsatile flow were markedly smaller than those of infants with nonpulsatile flow. The urine production during bypass and operation was significantly greater in the pulsatile group. The less volume requirement and less edema formation during bypass were noted in the pulsatile group. Infants receiving pulsatile flow recovered faster and less postoperative mechanical ventilation was necessary. The average plasma free Hb after rewarming in the pulsatile group was 55 mg/dl. Apparently, the pulsatile perfusion by PBP is safe and extremely useful in infant cardiopulmonary bypass.