Pulmonary Ventilation Should Be Matched With Pulmonary Perfusion During Cardiopulmonary Bypass

2012 ◽  
Vol 26 (5) ◽  
pp. e60 ◽  
Author(s):  
Tomas A. Salerno ◽  
Francisco Igor B. Macedo ◽  
Edward Gologorsky
Keyword(s):  
Cardiopulmonary Bypass ◽  
Pulmonary Ventilation ◽  
Pulmonary Perfusion

Beating Heart Surgery with Pulmonary Perfusion and Ventilation During Cardiopulmonary Bypass: Target Organs' Perfusion Without Plegia

2012 ◽  
Vol 24 (4) ◽  
pp. 308-310 ◽  
Author(s):  
Francisco Igor B. Macedo ◽  
Edward Gologorsky ◽  
Ana Claudia B.A. Costa ◽  
Si M. Pham ◽  
Tomas A. Salerno
Keyword(s):  
Cardiopulmonary Bypass ◽  
Heart Surgery ◽  
Beating Heart ◽  
Pulmonary Perfusion ◽  
Beating Heart Surgery ◽  
Target Organs

Pulmonary Perfusion With L-Arginine Ameliorates Post-Cardiopulmonary Bypass Lung Injury in a Rabbit Model

2011 ◽  
Vol 167 (2) ◽  
pp. e77-e83 ◽  
Author(s):  
Yin Kai Chao ◽  
Yi Cheng Wu ◽  
Kun Ju Yang ◽  
Ling Ling Chiang ◽  
Hui Ping Liu ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Lung Injury ◽  
Rabbit Model ◽  
Pulmonary Perfusion ◽  
Post Cardiopulmonary Bypass

Alveolar dead space, alveolar shunt, and transpulmonary pressure

1965 ◽  
Vol 20 (5) ◽  
pp. 816-824 ◽  
Author(s):  
J. M. Workman ◽  
R. W. B. Penman ◽  
B. Bromberger-Barnea ◽  
S. Permutt ◽  
R. L. Riley
Keyword(s):  
Dead Space ◽  
Pulmonary Ventilation ◽  
Transpulmonary Pressure ◽  
Lung Model ◽  
Pulmonary Perfusion ◽  
Alveolar Dead Space ◽  
Right Heart ◽  
Gradient Distribution ◽  
Right Heart Bypass ◽  
Heart Bypass

The effect of transpulmonary pressure (Ptp) on gas exchange in the dog lung was studied in 10 open-chested dogs. Rates of pulmonary perfusion and ventilation were held constant (right heart bypass and pump respirator) while Ptp was varied. Alveolar dead space ventilation and alveolar shunt perfusion were calculated from CO2 and O2 gradients. The results are finally expressed in terms of a three-compartment lung model. It is shown that a misinterpretation is possible if alveolar dead space or alveolar shunt compartments are expressed as fractions, respectively, of all ventilated or all perfused alveoli, therefore each has been expressed as a fraction of the whole lung. It is concluded that the alveolar shunt compartment decreased as Ptp was increased, over the lower range of Ptp studied. No significant change was detected in the alveolar dead space compartment, as Ptp was varied. alveolar-arterial O2 gradient; anatomical dead space; arterial-alveolar CO2 gradient; distribution of pulmonary perfusion; distribution of pulmonary ventilation; right heart bypass preparation; ventilation/perfusion relationships Submitted on February 16, 1965

Massive Pulmonary Infarction during Total Cardiopulmonary Bypass in Unanesthetized Spontaneously Breathing Lambs

1981 ◽  
Vol 4 (2) ◽  
pp. 76-81 ◽  
Author(s):  
T. Kolobow ◽  
R.G. Spragg ◽  
J.E. Pierce
Keyword(s):  
Blood Flow ◽  
Cardiopulmonary Bypass ◽  
Pulmonary Artery ◽  
Pulmonary Blood Flow ◽  
Pulmonary Ventilation ◽  
Venous Blood ◽  
Mixed Venous Blood ◽  
Pulmonary Infarction ◽  
Cardiopulmonary Support ◽  
Mixed Venous

We provided total cardiopulmonary support for 1-18 hours in unanesthetized tethered lambs by peripheral vascular cannulation, using a roller pump and the spiral membrane lung. Respirations were allowed to remain spontaneous and unaided. A Swan-Ganz catheter was placed for retrograde pulmonary artery blood flow sampling. Within a few minutes following induced ventricular fibrillation the PCO2 of sampled blood flowing retrograde through the lungs fell below 10 mm Hg, the PO2 rose to near 150 mm Hg, the pH rose to above 7.8, and the glucose level fell to less than 20 mg %. All of these values later gradually shifted, approaching mixed venous blood values within minutes. After 1-18 hrs of perfusion the animals went into shock and were sacrificed. At autopsy, the lungs of animals breathing room air were beefy and hemorrhagic. In lambs that were «breathing» CO2 enriched air the retrograde pulmonary artery blood pH and PCO2 was usually maintained close to the mixed venous blood values. The observed pulmonary changes were considerably less abnormal, and the microscopic abnormalities were at times nonexistent. We believe the integrity of pulmonary blood flow is vital to the survival of the lungs as a functioning organ. Cessation of total forward pulmonary blood flow (unlike partial cardiopulmonary bypass), combined with spontaneous pulmonary ventilation, rapidly leads to massive, pulmonary infactions, shock, and death.

Direct Measurement of Nitric Oxide during Experimental Cardiopulmonary Bypass

2005 ◽  
Vol 33 (3) ◽  
pp. 295-300
Author(s):  
S Hamanaka ◽  
K Tanemoto ◽  
E Inagaki ◽  
T Yamasawa ◽  
K Yoshida ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Cardiac Surgery ◽  
Cardiopulmonary Bypass ◽  
Pulmonary Ventilation ◽  
Cardiovascular Complications ◽  
Arterial Line ◽  
Membrane Oxygenator ◽  
Preliminary Validation ◽  
No Sensor ◽  
New System

We developed a system to measure nitric oxide (NO) concentration during cardiopulmonary bypass in anaesthetized pigs (n = 6). A T-shaped connector, attached to an NO sensor, was mounted in the extra-corporeal circuit at two measuring sites: proximal to the membrane oxygenator (venous side) and distal to the arterial line filter (arterial side). After performing a preliminary validation study, we measured plasma NO concentration before and during total cardiopulmonary bypass circulation (non-pulsatile flow 1.5 l/min) and without pulmonary ventilation. After establishing bypass, PaO2 was 318-393 mmHg; when PaO2 was decreased to 80-100 mmHg, plasma NO concentration in the arterial circuit fell by 39.2 ± 15.6 nM. There was no observable change in plasma NO concentration at the venous circuit. This new system could be useful in monitoring NO concentration during cardiac surgery with cardiopulmonary bypass, and for understanding the possible pathophysiological roles of hyper-nitric oxaemia in cardiopulmonary bypass-related cardiovascular complications.

Continuous pulmonary perfusion during cardiopulmonary bypass prevents lung injury in infants

2000 ◽  
Vol 69 (2) ◽  
pp. 602-606 ◽  
Author(s):  
Takaaki Suzuki ◽  
Toyoki Fukuda ◽  
Tsutomu Ito ◽  
Yoshito Inoue ◽  
Yasunori Cho ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Lung Injury ◽  
Pulmonary Perfusion

scholarly journals Lung Protection Strategies during Cardiopulmonary Bypass Affect the Composition of Bronchoalveolar Fluid and Lung Tissue in Cardiac Surgery Patients

Metabolites ◽  
2018 ◽  
Vol 8 (4) ◽  
pp. 54 ◽  
Author(s):  
Raluca Maltesen ◽  
Katrine Buggeskov ◽  
Claus Andersen ◽  
Ronni Plovsing ◽  
Reinhard Wimmer ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Lung Tissue ◽  
Ischemia Reperfusion ◽  
Inflammatory Cells ◽  
Lavage Fluid ◽  
Acid Oxidation ◽  
Pulmonary Perfusion ◽  
Standard Regimen ◽  
Lung Protection ◽  
Cell Counts

Pulmonary dysfunction is among the most frequent complications to cardiac surgeries. Exposure of blood to the cardiopulmonary bypass (CPB) circuit with subsequent lung ischemia-reperfusion leads to the production of inflammatory mediators and increases in microvascular permeability. The study aimed to elucidate histological, cellular, and metabolite changes following two lung protective regimens during CPB with Histidine-Tryptophan-Ketoglutarate (HTK) enriched or warm oxygenated blood pulmonary perfusion compared to standard regimen with no pulmonary perfusion. A total of 90 patients undergoing CPB were randomized to receiving HTK, oxygenated blood or standard regimen. Of these, bronchoalveolar lavage fluid (BALF) and lung tissue biopsies were obtained before and after CPB from 47 and 25 patients, respectively. Histopathological scores, BALF cell counts and metabolite screening were assessed. Multivariate and univariate analyses were performed. Profound histological, cellular, and metabolic changes were identified in all patients after CPB. Histological and cellular changes were similar in the three groups; however, some metabolite profiles were different in the HTK patients. While all patients presented an increase in inflammatory cells, metabolic acidosis, protease activity and oxidative stress, HTK patients seemed to be protected against severe acidosis, excessive fatty acid oxidation, and inflammation during ischemia-reperfusion. Additional studies are needed to confirm these findings.

scholarly journals Pulmonary artery perfusion versus no pulmonary perfusion during cardiopulmonary bypass in patients with COPD: a randomised clinical trial

2016 ◽  
Vol 3 (1) ◽  
pp. e000146 ◽  
Author(s):  
Katrine B Buggeskov ◽  
Martin M Sundskard ◽  
Thomas Jonassen ◽  
Lars W Andersen ◽  
Niels H Secher ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cardiopulmonary Bypass ◽  
Pulmonary Artery ◽  
Randomised Clinical Trial ◽  
Pulmonary Perfusion ◽  
Artery Perfusion
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