Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

UNLABELLED: The impact of perfusion technique and mode of pH management during cardiopulmonary bypass has not been well characterized with respect to postoperative cardiovascular outcome. METHODS: This double-blind, randomized study comparing outcomes after alpha-stat or pH-stat management and pulsatile or nonpulsatile perfusion during moderate hypothermic cardiopulmonary bypass was undertaken in 316 patients undergoing coronary artery bypass operations. RESULTS: Cardiovascular morbidity and mortality were not affected by pH management, and the incidence of stroke (2.5%) did not differ between groups. Overall in-hospital mortality was 2.8%, eight of the nine deaths occurring in the nonpulsatile group (5.1% versus 0.6%; p = 0.018). The incidence of myocardial infarction was 5.7% in the nonpulsatile group and 0.6% in the pulsatile group (p = 0.010), and use of intraaortic balloon pulsation was significantly more common in the nonpulsatile group (7.0% versus 1.9%; p = 0.029). The overall percentage of patients having major complications was also significantly higher in the nonpulsatile group (15.2% versus 5.7%; p = 0.006). Duration of cardiopulmonary bypass, age, and use of nonpulsatile perfusion all correlated significantly with adverse outcome. CONCLUSIONS: Use of pulsatile perfusion during cardiopulmonary bypass was associated with decreased incidences of myocardial infarction, death, and major complications.

Original publication

DOI

10.1016/S0022-5223(95)70229-6

Type

Journal article

Journal

J Thorac Cardiovasc Surg

Publication Date

08/1995

Volume

110

Pages

340 - 348

Keywords

Aged, Arrhythmias, Cardiac, Blood Pressure, Carbon Dioxide, Cardiopulmonary Bypass, Cerebrovascular Disorders, Coronary Artery Bypass, Double-Blind Method, Female, Humans, Hydrogen-Ion Concentration, Intra-Aortic Balloon Pumping, Male, Middle Aged, Myocardial Infarction, Postoperative Care, Postoperative Complications, Prospective Studies, Pulsatile Flow, Renal Insufficiency, Risk Factors