2007
DOI: 10.1177/0267659107080115
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Review Article: Comparison of perfusion modes on microcirculation during acute and chronic cardiac support: is there a difference?

Abstract: Although heart-lung machines and cardiac assist devices have been used successfully for acute and chronic cardiac support for decades, controversies still remain concerning the benefits of pulsatile and non-pulsatile perfusion. The core of the debate is whether enough energy is generated by the artificial pulse to keep capillary beds open and cell metabolism stabilized during acute or chronic cardiac support. In other words, does artificial pulsatility exist in the microcirculation: small vessels of less than … Show more

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Cited by 47 publications
(30 citation statements)
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“…Investigators have also shown that when extra energy is generated by pulsatile perfusion, regional and global vital organ perfusion is superior compared with that in nonpulsatile perfusion. 9 In previous studies from our group performed in similar experimental settings using T-PLS, pulsatile flow had a beneficial effect on organ perfusion when compared with nonpulsatile flow, especially in the kidney and coronary arteries. [2][3][4] Higher SHE may be a driving force in preserving microcirculation, therefore enabling organ preservation after extracorporeal circulation, although a large part of the hemodynamic energy seems to be lost in the circuit.…”
Section: Discussionmentioning
confidence: 76%
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“…Investigators have also shown that when extra energy is generated by pulsatile perfusion, regional and global vital organ perfusion is superior compared with that in nonpulsatile perfusion. 9 In previous studies from our group performed in similar experimental settings using T-PLS, pulsatile flow had a beneficial effect on organ perfusion when compared with nonpulsatile flow, especially in the kidney and coronary arteries. [2][3][4] Higher SHE may be a driving force in preserving microcirculation, therefore enabling organ preservation after extracorporeal circulation, although a large part of the hemodynamic energy seems to be lost in the circuit.…”
Section: Discussionmentioning
confidence: 76%
“…With 100% nonpulsatile flow, SHE is 0. 9 This extra energy generated by pulsatile flow may maintain better regional and global blood flow to vital organs. 10,11 Another cause for the controversy between pulsatile and nonpulsatile flow is the significant design variations seen in clinical and experimental research performed to date.…”
mentioning
confidence: 99%
“…Almost all contemporary roller pumps are equipped with a pulsatile mode. Pulsatile flow during CPB procedures is considered to be superior to nonpulsatile flow at preserving microcirculation (2,3). We have tested six pediatric CPB pumps in piglet models and found that the majority generated significantly higher hemodynamic energy than the conventional, nonpulsatile pumps (4).…”
Section: Blood Pumpmentioning
confidence: 99%
“…Кроме того, в последние годы вновь стали под-ниматься ранее дискуссируемые вопросы о важнос-ти для организма пульсирующего давления и кро-вотока, влияющих на микроциркуляцию органов и тканей [18][19][20][21][22].…”
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