Research On The Effects Of Vital Organs Structure And Function With The Pulsatile And Non-Pulsatile Perfusion

Objective1.Verify pneumatic pump in pulsatile perfusion during cardiopulmonary bypass in the feasibility, validate its post-oxygenation in the pneumatic pump in the feasibility of perfusion pump.2.From the theory further proof of pulsatile perfusion in the structure and function of important organs of protection is superior to the stratospheric Perfusion.Methods1.The use of pneumatic actuators, pneumatic diaphragm pumps, membrane oxygenation, and the establishment of off-pump bypass pipe loop determination of pulsatile cardiopulmonary bypass device performance, stability, and related data.2.Select 15 dogs, these dogs weighing 18-20kg, age 2-5 years old, in good health. These dogs Were randomly divided into experimental group and control group, with the current clinical generic "stratosphere" perfusion during cardiopulmonary bypass perfusion own way as the control group (non-pulsatile perfusion group, the NPP group); Produced by balloon pulsatile pump generated pulsatile perfusion during cardiopulmonary bypass pulsatile blood flow popular as the experimental group (pulsatile perfusion group, the PP group). To observ two kinds of perfusion of vital organs of the dog. Results1. Devices are able to continuously operate,stable performance of these devices. Polymer membranes well tolerated。Able to high-intensity continuous. The factors those can affect the effect of pulsatile perfusion including positive and negative drive pressure, pulse frequency, and duty cycle.2. There was no significant difference in the results of RBC, PLT, HGB in Two groups(P>0.05). It means that both groups of blood damage during cardiopulmonary bypass mode,moreover, the more serious of the blood destruction with the extension of CPB. The results of pH, PCO2, PO2 were no significant difference in two groups(P>0.05).The LAC have significant differences in Pulsatile perfusion group compared with the control group 3 hours after CPB(P<0.05), the difference was statistically compared with the preoperative group(P<0.01). This prompted that at the same perfusion time , the lactic acid of pulsatile perfusion group were lower than the non-pulsatile perfusion group ,the microcirculatory perfusion in the pulsatile perfusion group is superior to the non-pulsatile perfusion group . However, when compared with the preoperative data is still a marked increase in lactic acid. The results of BUN, Cr, AST, ALT results there was no significant difference(P>0.05).But ,the BUN, Cr, AST, ALT CK-MB increased significantly compared with the preoperative 6 hours after CPB , with statistically significant (P<0.01). Pulsatile perfusion group BUN, Cr, AST, ALT increases were below the non-pulsatile perfusion group, with statistically significan(tP<0.01, P<0.05). This shows that the pulsatile perfusion on the heart, liver and other organs have a certain protective effect , this protective effect would be more evident with time prolonged .There was no significant difference in the results of the two groups FHb,comparing the data in the same group,the FHB increase was not obvious 2 hours after cardiopulmonary bypass. FHB was significantly higher 3,4,5 and 6 hours after CPB , It compared with 1 hour after CPB, statistically significant. And with time prolonged, the difference become more obvious, suggesting that more severe damage of blood components.3. The structure of Heart, liver, lung, kidney was basically normal by the experimental observation of Biopsy specimens. In the non-pulsatile perfusion group there were some tissue cell degeneration occurs, with mild cell lysis phenomenon. The pulsatile perfusion group were better than the non-pulsatile perfusion group were. On the peripheral microcirculation of dogs observed. In the beginning of CPB, with the temperature drop the capillaries were closed, reducing the number of blood vessels, blood flow slowed down, stream or line by line into a mitochondrial particles slow down the stream flow, grain flow, or even stagnation, with mild blood cells aggregation. However, in the perfusion group with pulsating high flow will gradually open capillaries, and the increase in the number gradually reduced red blood cell aggregation, showing dotted line-like movement, and then blood flow velocity has quickened.Conclutions1. Pulsatile perfusion and non-pulsatile perfusion can safely and effectively used in cardiopulmonary bypass. Use of gas-driven line of pulse-type pump is feasible. But there are many issues to be resolved2. Pulsatile perfusion during cardiopulmonary bypass on the heart, liver, kidney and other important organs do have a protective effect. Pulsatile perfusion has a good effect on improving the peripheral circulation, but high pressure is still greater damage to blood components.