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(Chest. 1972;61:65-69.)
© 1972 American College of Chest Physicians

Comparison of Nonpulsatile and Pulsatile Extracorporeal Circulation on Renal Tissue Perfusion

John C. German M.D.1; George S. Chalmers M.D.2; Junichi Hirai M.D.2; Nrisingha D. Mukherjee M.D.2; Akio Wakabayashi M.D.3; and John E. Connolly M.D., F.C.C.P.4

1 Resident in Surgery
2 Department of Surgery, University of California, Irvine
3 Assistant Professor
4 Professor and Chairman

This study was designed to compare the physiologic effects of nonpulsatile (NP) and pulsatile (P) perfusion on the kidney. Serial specimens for blood gases and serum lactic acid (L) were taken from the renal artery and vein in three groups of dogs; one group served as control. The aortic arch was crossclamped and NP and P left atrial to left subclavian artery bypass was performed for two hours on two groups of dogs. Renal blood flow (RBF) and arterial (AP) and the venous pressures (VP) were continuously monitored. Vascular resistance (VR) was calculated by the formula VR = (AP—VP)/RBF. In order to maintain nearly equal arterial pressures above and below the crossclamped aorta, a higher flow rate was required with NP (80 ml/kg/min) than with P (60 ml/Kg/min). Marked reduction in pH (7.255) along with elevated L (50 mg/100 ml) were consistent with NP. There was less reduction in pH (7.37) and less elevation of L (35 mg/100 ml) with P, whereas control pH was 7.37 and L was 17 mg/ml. Pulsatile pumping provides better tissue perfusion during extracorporeal bypass.




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