Intra-aortic balloon pump induced pulsatile perfusion reduces endothelial activation and inflammatory response following cardiopulmonary bypass

Abstract

IABP-induced pulsatile perfusion allows lower endothelial activation during CPB and higher anti-inflammatory cytokines secretion.

Off-pump coronary artery bypass surgery versus standard linear or pulsatile cardiopulmonary bypass: endothelial activation and inflammatory response

“…A significant, systemic endothelial response -as measured by MCP-1 and VEGF release -occurred after all three types of surgery, but it was significantly more pronounced with CPB use. The interaction of leucocytes with endothelium, via specific receptors, may provide intracellular signals that activate the expression of surface receptors and chemokines [13,14]. Our findings agree with the previous reports of increased circulating endothelial cells and increased endothelial cell apoptosis with on-pump versus off-pump CABG.…”

“…Change into a linear pulsatile flow triggered endothelial cell activation, with its corresponding alteration to a cuboidal shape and depolarised state [19]. Sequential change from a pulsatile, then to a linear and then back to a pulsatile state during standard LCPB (corresponding to the time before aortic cross-clamping, the cross-clamping time and the declamping time, respectively, in cardiac surgery in vivo) might mimic this in vitro endothelial reaction, leading to different endothelial activation, as we noted in another study [13]. These data may also explain the contradictory results obtained with different types of pulsatile devices.…”

Microvascular fluid exchange during pulsatile cardiopulmonary bypass perfusion with the combined use of a nonpulsatile pump and intra-aortic balloon pump

“…In the present study, the pattern of proinflammatory markers was similar in both groups and essentially in line with the study by Onorati et al, 25 in which inflammation was identical whether the perfusion was pulsatile or nonpulsatile.…”

The Association Between Pulsatile Cardiopulmonary Bypass and Acute Kidney Injury After Cardiac Surgery: A Before-and-After Study

“…Pulsatile flow appears to provide better microvasular flow, reduced inflammatory response, and possibly improved organ function parameters when compared with nonpulsatile flow. [8][9][10][11] There also may be a reduced need for hemofiltration in higher risk patients undergoing cardiac surgery. 12 To date, most studies examining pulsatile CPB have been small or observational.…”