Abstract

Background:Patients with chronic obstructive pulmonary disease have an increased risk of mortality and morbidity after open-heart surgery. This is mostly due to a dysfunction of the pulmonary system during and after non-pulsatile cardiopulmonary bypass. The purpose of this study was to compare the pulsatile and non-pulsatile blood flows during cardiopulmonary bypass in patients with chronic obstructive pulmonary disease.Material/Methods:This is a prospective study. Ten patients with chronic obstructive pulmonary disease had open-heart surgery with pulsatile flow, and another 9 patients with non-pulsatile flow. We compared clinical, hemodynamic, biochemical and hematological parameters and arterial and venous blood gases before initiating cardiopulmonary bypass, at aortic cross-clamping and de-clamping, and 1 and 24 hours postoperative.Results:In the pulsatile flow group, systemic vascular resistance at the time of aortic cross clamping (p=0.041), pulmonary vascular resistance 1 hour postoperative (p=0.05), and the percentage of neutrophils 1 hour postoperative (p=0.034) were significantly lower than those of the non-pulsatile group. Though white blood cell count was significantly high in the pulsatile group 1 hour postoperative, absolute neutrophil count was significantly low (p=0.034). The postoperative mechanical ventilation period was significantly shorter in the pulsatile flow group (p=0.016).Conclusions:Pulsatile blood flow during cardiopulmonary bypass has a favorable influence on patients with chronic obstructive pulmonary disease, who have high risk in open-heart surgery.

Keywords: Blood Gas Analysis, Blood Pressure, Cardiopulmonary Bypass - methods, Hemodynamic Processes, Leukocyte Count, Postoperative Care - methods, Postoperative Care - statistics & numerical data, Postoperative Care - utilization, Prospective Studies, Pulmonary Circulation - physiology, Pulmonary Disease, Chronic Obstructive - blood, Pulmonary Disease, Chronic Obstructive - surgery, Pulsatile Flow, Vascular Resistance, Blood Gas Analysis, Blood Pressure, Cardiopulmonary Bypass - methods, Hemodynamics, Leukocyte Count, Postoperative Care - utilization, Prospective Studies, Pulmonary Circulation - physiology, Pulmonary Disease, Chronic Obstructive - surgery, Pulsatile Flow, Vascular Resistance