Comparison studies of major organ microcirculations under pulsatile- and nonpulsatile-assisted circulations.

In these comparison studies, we examined changes in major organ microcirculations during circulatory support using pulsatile and nonpulsatile pumps. Acute myocardial infarction was created by left anterior descending (LAD) branch ligation. After the animals in these studies fell into cardiogenic shock, they were supported by mechanical assist devices: a pulsatile ventricular assist device (VAD) in 4 pigs, a nonpulsatile VAD in 4 pigs, and an intraaortic balloon pumping (IABP) plus nonpulsatile VAD in 4 pigs. Each group was supported for 3 h with an identical mean aortic pressure being maintained. As for parameters, the stomach mucosa, liver regional blood flow, stomach mucosal pH, and arterial blood keton body ratio (AKBR) were measured. Both regional blood flow and AKBR increased in the pulsatile group as compared with the nonpulsatile group. There were no differences in the stomach mucosal pH among the 3 groups. These results suggest that pulsatile assist rather than the nonpulsatile assist plays a significant role in the recovery of deteriorated splanchnic organs due to cardiogenic shock.