Kim Hyun Koo, Son Ho Sung, Fang Yong Hu, Park Sung Young, Hwang Chang Mo, Sun Kyung
Department of Thoracic and Cardiovascular Surgery, Korea University, Seoul, Korea.
ASAIO J. 2005 Jan-Feb;51(1):30-6. doi: 10.1097/01.mat.0000150324.02040.b4.
This study was conducted to directly compare the effects of pulsatile and nonpulsatile blood flow in the extracorporeal circulation upon renal tissue perfusion by using a tissue perfusion measurement system. A total cardiopulmonary bypass circuit was constructed to accommodate twelve Yorkshire swine, weighing 20 approximately 30 kg. Animals were randomly assigned to group 1 (n = 6, nonpulsatile centrifugal pump) or group 2 (n = 6, pulsatile T-PLS pump). A tissue perfusion measurement probe (Q-Flow 500) was inserted into the renal parenchymal tissue, and the extracorporeal circulation was maintained for an hour at a pump flow rate of 2 L/min after aortic cross-clamping. Tissue perfusion flow in the kidney was measured before bypass and every 10 minutes after bypass. Renal tissue perfusion flow was substantially higher in the pulsatile group throughout bypass (ranging 48.5-64.1 ml/min/100 g in group 1 vs. 51.0-88.1 ml/min/100 g in group 2). The intergroup difference was significant at 30 minutes (47.5 +/- 18.3 ml/min/100 g in group 1 vs. 83.4 +/- 28.5 ml/min/100 g in group 2; p = 0.026). Pulsatile flow achieves higher levels of tissue perfusion of the kidney during short-term extracorporeal circulation. A further study is required to observe the effects of pulsatile flow upon other vital organs and its long-term significance.
本研究旨在通过使用组织灌注测量系统，直接比较体外循环中搏动性血流和非搏动性血流对肾组织灌注的影响。构建了一个全心肺转流回路，以容纳12只体重约20至30千克的约克郡猪。动物被随机分为第1组（n = 6，非搏动性离心泵）或第2组（n = 6，搏动性T-PLS泵）。将一个组织灌注测量探头（Q-Flow 500）插入肾实质组织，在主动脉交叉钳夹后，以2升/分钟的泵流速维持体外循环1小时。在体外循环前以及体外循环后每隔10分钟测量肾脏的组织灌注流量。在整个体外循环过程中，搏动性血流组的肾组织灌注流量显著更高（第1组为48.5 - 64.1毫升/分钟/100克，而第2组为51.0 - 88.1毫升/分钟/100克）。两组间差异在30分钟时具有显著性（第1组为47.5 +/- 18.3毫升/分钟/100克，第2组为83.4 +/- 28.5毫升/分钟/100克；p = 0.026）。在短期体外循环期间，搏动性血流可实现更高水平的肾脏组织灌注。需要进一步研究以观察搏动性血流对其他重要器官的影响及其长期意义。
