Journal of cardiothoracic and vascular anesthesia
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J. Cardiothorac. Vasc. Anesth. · Jun 1997
Acetylcholine reactivity in the pulmonary artery during cardiac surgery in patients with ischemic or valvular heart disease.
During cardiopulmonary bypass, there is almost no blood flow through the pulmonary artery. Ischemia and reperfusion are known to attenuate the reaction to acetylcholine. An attenuated reactivity to acetylcholine in the pulmonary circulation after cardiopulmonary bypass was previously shown in children. The current study in adult patients was designed to analyze the change over time of acetylcholine reactivity after cardiac surgery. ⋯ These results confirm the finding of altered reactivity to acetylcholine in the pulmonary circulation after cardiopulmonary bypass. In view of the often prolonged tendency toward pulmonary hypertension observed in children, the recovery at 8 hours after surgery was unexpectedly rapid. The attenuated response to acetylcholine is most likely explained by relative ischemia in the pulmonary circulation during cardiopulmonary bypass.
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J. Cardiothorac. Vasc. Anesth. · Jun 1997
The effects of pulsatile cardiopulmonary bypass on cerebral and renal blood flow in dogs.
The purpose of this study was to determine the effects of pulsatility on cerebral blood flow, cerebral metabolism, and renal blood flow over a range of cardiopulmonary bypass temperature and flow conditions. ⋯ Pulsatility has no significant effect on cerebral or renal perfusion over a broad range of cardiopulmonary bypass temperature and flow conditions. Cerebral blood flow and metabolism were functions of temperature but not pulsatility or flow rate. Renal blood flow was affected by both temperature and cardiopulmonary bypass flow rate but not by pulsatility. Finally, central nervous system perfusion may be preserved under low-flow cardiopulmonary bypass conditions by shunting of perfusion from splanchnic vascular beds.