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May 1, 1993Artificial Organs

The Renin‐Angiotensin‐Aldosterone System and Hematologic Changes During Pulsatile and Nonpulsatile Cardiopulmonary Bypass

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Key result

Pulsatile perfusion during cardiopulmonary bypass significantly increased plasma free hemoglobin levels compared to nonpulsatile perfusion, with no benefit on vasoactive hormones.

Why the study?

Does pulsatile cardiopulmonary bypass using a roller pump improve vasoactive hormone levels or hematologic changes compared to nonpulsatile bypass in patients undergoing elective primary CABG?

Population

32 patients subjected to elective primary coronary artery bypass graft surgery

Comparison

Pulsatile cardiopulmonary bypass using a roller… vs Nonpulsatile cardiopulmonary bypass using a…

Design

Cohort

Follow-up

during and after cardiopulmonary bypass

Authors

MGMasahiro GotoKyushu UniversityKKKazunori KudohJuntendo UniversitySMShigeru MinamiOsaka University Hospital

Discussion

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Implication

Pulsatile perfusion was associated with increased hemolysis and no hormonal benefit in CABG; leaves open whether pulsatility merits randomized evaluation.

Study Design

Type

Observational (n=32)

Structured PICO

Does pulsatile cardiopulmonary bypass using a roller pump improve vasoactive hormone levels or hematologic changes compared to nonpulsatile bypass in patients undergoing elective primary CABG?

P
Population
32 patients undergoing elective primary coronary artery bypass graft surgery.
E
Exposure
Pulsatile cardiopulmonary bypass using a roller pump during the period of cardiac arrest
C
Comparator
Nonpulsatile cardiopulmonary bypass using a roller pump during the period of cardiac arrest
O
Outcome
Levels of vasoactive hormones (plasma renin, angiotensin II, aldosterone, epinephrine, and norepinephrine) and hematologic changes (plasma free hemoglobin, number of platelets, platelet factor 4, and beta-thromboglobulin)surrogate

Pulsatile cardiopulmonary bypass using a roller pump does not offer benefits regarding vasoactive hormones and is associated with increased hemolysis compared to nonpulsatile perfusion.

Cite This Study

Goto et al. (1993) conducted an observational in Elective primary coronary artery bypass graft surgery (n=32). Pulsatile perfusion using a roller pump vs. Nonpulsatile perfusion was evaluated on Levels of vasoactive hormones and hematologic changes. Pulsatile perfusion during cardiopulmonary bypass significantly increased plasma free hemoglobin levels compared to nonpulsatile perfusion, with no benefit on vasoactive hormones.

synapsesocial.com/papers/6a97cce255a55e94cce34e9ehttps://doi.org/10.1111/j.1525-1594.1993.tb00587.x
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Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Role of angiotensin II in the development of peripheral vasoconstriction during cardiopulmonary bypass1979 · 30 citations
  2. 2Relationship between Plasma Concentrations of Angiotensin I, Angiotensin II and Plasma Renin Activity during Cardio‐Pulmonary Bypass in Man*1974 · 52 citations
  3. 3Peripheral vascular resistance and angiotensin II levels during pulsatile and no-pulsatile cardiopulmonary bypass.1979 · 152 citations