Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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The Effect of Pulsatile Versus Nonpulsatile Blood Flow on Viscoelasticity and Red Blood Cell Aggregation in Extracorporeal Circulation

  • Ahn, Chi Bum (Department of Molecular Medicine, Gachon University Graduate School of Medicine) ;
  • Kang, Yang Jun (Department of Mechatronics, Gwangju Institute of Science and Technology) ;
  • Kim, Myoung Gon (Department of Mechatronics, Gwangju Institute of Science and Technology) ;
  • Yang, Sung (Department of Mechatronics, Gwangju Institute of Science and Technology) ;
  • Lim, Choon Hak (Department of Anesthesiology and Pain Medicine, Korea University Medical Center) ;
  • Son, Ho Sung (Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center) ;
  • Kim, Ji Sung (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Lee, So Young (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Son, Kuk Hui (Department of Thoracic and Cardiovascular Surgery, Gachon University Gil Medical Center, Gachon University College of Medicine) ;
  • Sun, Kyung (Department of Thoracic and Cardiovascular Surgery, Korea University Medical Center)
  • Received : 2015.08.18
  • Accepted : 2015.09.30
  • Published : 2016.06.05
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Abstract

Background: Extracorporeal circulation (ECC) can induce alterations in blood viscoelasticity and cause red blood cell (RBC) aggregation. In this study, the authors evaluated the effects of pump flow pulsatility on blood viscoelasticity and RBC aggregation. Methods: Mongrel dogs were randomly assigned to two groups: a nonpulsatile pump group (n=6) or a pulsatile pump group (n=6). After ECC was started at a pump flow rate of 80 mL/kg/min, cardiac fibrillation was induced. Blood sampling was performed before and at 1, 2, and 3 hours after ECC commencement. To eliminate bias induced by hematocrit and plasma, all blood samples were adjusted to a hematocrit of 45% using baseline plasma. Blood viscoelasticity, plasma viscosity, hematocrit, arterial blood gas analysis, central venous $O_2$ saturation, and lactate were measured. Results: The blood viscosity and aggregation index decreased abruptly 1 hour after ECC and then remained low during ECC in both groups, but blood elasticity did not change during ECC. Blood viscosity, blood elasticity, plasma viscosity, and the aggregation index were not significantly different in the groups at any time. Hematocrit decreased abruptly 1 hour after ECC in both groups due to dilution by the priming solution used. Conclusion: After ECC, blood viscoelasticity and RBC aggregation were not different in the pulsatile and nonpulsatile groups in the adult dog model. Furthermore, pulsatile flow did not have a more harmful effect on blood viscoelasticity or RBC aggregation than nonpulsatile flow.

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References

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