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Comparative Study Clinical Trial
The impact of haemodilution and bypass pump flow on cerebral oxygen desaturation during cardiopulmonary bypass--A comparison of two systems of cardiopulmonary bypass.
- M J Bennett, M Weatherall, G Webb, S F Dudnikov, and C T Lloyd.
- Department of Cardiothoracic Anaesthesia, South West Cardiothoracic Centre, Plymouth, UK mark.bennett4@nhs.net.
- Perfusion. 2015 Jul 1; 30 (5): 389-94.
ObjectiveTo determine the influence of haemodilution, bypass flow rates and calculated oxygen delivery during cardiopulmonary bypass (CPB) with either a conventional CPB (C-CPB) circuit or a miniaturised (Mini-CPB) circuit on cerebral oxygen desaturation. The effect of minimal haemodilution with a Mini-CPB was investigated.ParticipantsEighty patients scheduled for elective cardiac surgery.InterventionOxygenated haemoglobin (O2Hb) and tissue oxygenation index (TOI) were measured with near-infrared spectroscopy (NIRS).ResultsThe average indexed bypass pump flow was significantly lower with Mini-CPB. When combined with haemoglobin concentration, the average oxygen delivery was the same between groups. Patients in the C-CPB group had a greater duration and severity of cerebral desaturation to a level <20% below baseline values, but none reached the depth and duration of the cerebral desaturation associated with poor outcome. Cerebral oxygen desaturation with C-CPB was significantly associated with low flows during bypass, whereas desaturation with Mini-CPB was associated with low perioperative haemoglobin concentration.© The Author(s) 2014.
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