Comparison of pulsatile versus nonpulsatile perfusion on the postcardiopulmonary bypass aortic-radial artery pressure gradient.

OBJECTIVE

To investigate whether the type of perfusion, pulsatile (PP) or nonpulsatile (NP), has any effect on the pressure gradient that exists between the aortic root and the radial artery after cardiopulmonary bypass (CPB).

DESIGN

Prospective, randomized study.

SETTING

Tertiary care, university hospital.

PARTICIPANTS

Eighty patients undergoing elective, hypothermic coronary artery bypass graft (CABG) surgery.

INTERVENTIONS

Pulsatile perfusion with a pulse pressure of 10 to 20 mmHg and a frequency of 60 to 80 beats/min was created during the hypothermic phase of CPB. Both the radial artery and aorta were cannulated and attached to separate transducers but displayed and analyzed on the same monitor.

MEASUREMENTS AND MAIN RESULTS

Simultaneous recordings of radial artery and aortic root blood pressure were made prebypass, during CPB, and after discontinuation of CPB at 2, 5, and 10 minutes. During CPB, the PP group had a significantly higher mean pulse pressure measured at the aortic root than the NP group (15.5 +/- 8.1 v 1.7 +/- 2.7, p < 0.0001). The aortic-to-radial-artery gradient within both groups was significantly different after CPB for systolic (SBP), diastolic (DBP), and mean pressure (MAP) (p < 0.0001). There were, however, no statistically significant differences between the PP and NP groups in the aortic-to-radial-artery gradient after CPB for either SBP, DBP, or MAP.

CONCLUSIONS

Pulsatile perfusion had no effect on the aortic root radial artery blood pressure gradient after CPB in elective CABG surgery patients.