AN EVALUATION OF THE BENEFITS OF PULSATILE VS. NON-PULSATILE PERFUSION DURING CARDIOPULMONARY BYPASS PROCEDURES IN PEDIATRIC AND ADULT CARDIAC PATIENTS

Abstract

Introduction: The controversy over the benefits of pulsatile and non-pulsatile flow during cardiopulmonary bypass (CPB) procedures continues. The objectives of this investigation are to review the literature in order to clarify the truths and dispel the myths regarding the mode of perfusion used during open-heart surgery in pediatric and adult patients. Materials and Methods The Google and Medline databases were used to determine all of the published literature on pulsatile vs. non-pulsatile perfusion between 1952 and 2006. We found 228 articles related to this topic in the literature. Results Based on our literature search, we determined that pulsatile flow significantly improved blood flow of the vital organs including brain, heart, liver and pancreas, reduced the systemic inflammatory response syndrome, and decreased the incidence of post-operative deaths in pediatric and adult patients. We also found evidence that pulsatile flow significantly improved vital organ recovery in several types of animal models when compared to non-pulsatile perfusion. Several investigators have also shown that pulsatile flow generates more hemodynamic energy which maintains better microcirculation compared to non-pulsatile flow. Conclusion These results clearly suggest that pulsatile flow is superior to non-pulsatile flow during and after open-heart surgery in pediatric and adult patients.