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Retrograde Aortic Perfusion by Partial Cardiopulmonary Bypass: Effect of Mixing on Measured Arterial Oxygen Tension

Retrograde Aortic Perfusion by Partial Cardiopulmonary Bypass: Effect of Mixing on Measured... Abstract Partial venoarterial bypass with return of oxygenated blood to the femoral artery can produce mixing in the aorta of the blood from the oxygenator and left ventricular sources at flow rates of less than 50% of the total body flow. This was observed in six anesthetized sheep with normal lungs maintained on controlled ventilation on partial cardiopulmonary (venoarterial) bypass. The evidence of mixing increases with the extracorporeal flow rate, reaching the aortic arch in a majority of cases at the higher rates. Management of bypass and the interpretation of its effects depend on definite knowledge of the presence or absence of mixing. Partial bypass will raise the arterial oxygen tension (Pao2) of the blood continuing to flow through the lungs. This effect is independent of mixing (Pao2) and may be related either to the addition of oxygen to the blood or to an enhanced pulmonary ventilation-perfusion relationship. References 1. Hanson EL, Drinker PA, Don HF, et al: Venoarterial bypass with a membrane oxygenator: Successful respiratory support in a woman following pulmonary hemorrhage secondary to renal failure . Surgery 75:557-565, 1974.Crossref 2. Don H, Drinker PA, Hanson EL, et al: Arterial oxygenation: Mechanisms for improvement during partial cardiopulmonary support . JAMA 228:1419-1420, 1974.Crossref 3. Schuhmann RE, Geddes LA, Hoff HF: Prolonged left ventricular bypass by transvalvular aortic catheterization: Physiologic effects and rationale of surgical concept . Surgery 67:957-968, 1970. 4. Hill JD, O'Brien TG, Murray JJ, etal: Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome): Use of the Bramson membrane lung . N Engl J Med 286:629-634, 1972.Crossref 5. Soeter JR, Smith GT, Anema RJ, et al: Distribution of oxygenated blood in femoral and brachial artery perfusion during venoarterial bypass in primates . J Thorac Cardiovasc Surg 65:825-829, 1973. 6. Kanarek D, Zapol W, Ahluwali B, et al: Radionuclide imaging of the distribution of membrane lung perfusion , abstracted. Trans Am Soc Artif Intern Organs 3:35, 1974. 7. Zimberg YH, Lynch CG: Controlled operative atelectasis . Ann Thorac Surg 5:325-332, 1968.Crossref 8. Corso PJ, Geelhoed GW, Joseph WL: Membrane lung oxygenation for temporary support of the failing transplanted lung . Trans Am Soc Artif Intern Organs 19:525-528, 1973.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Retrograde Aortic Perfusion by Partial Cardiopulmonary Bypass: Effect of Mixing on Measured Arterial Oxygen Tension

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1975.01360070086015
Publisher site
See Article on Publisher Site

Abstract

Abstract Partial venoarterial bypass with return of oxygenated blood to the femoral artery can produce mixing in the aorta of the blood from the oxygenator and left ventricular sources at flow rates of less than 50% of the total body flow. This was observed in six anesthetized sheep with normal lungs maintained on controlled ventilation on partial cardiopulmonary (venoarterial) bypass. The evidence of mixing increases with the extracorporeal flow rate, reaching the aortic arch in a majority of cases at the higher rates. Management of bypass and the interpretation of its effects depend on definite knowledge of the presence or absence of mixing. Partial bypass will raise the arterial oxygen tension (Pao2) of the blood continuing to flow through the lungs. This effect is independent of mixing (Pao2) and may be related either to the addition of oxygen to the blood or to an enhanced pulmonary ventilation-perfusion relationship. References 1. Hanson EL, Drinker PA, Don HF, et al: Venoarterial bypass with a membrane oxygenator: Successful respiratory support in a woman following pulmonary hemorrhage secondary to renal failure . Surgery 75:557-565, 1974.Crossref 2. Don H, Drinker PA, Hanson EL, et al: Arterial oxygenation: Mechanisms for improvement during partial cardiopulmonary support . JAMA 228:1419-1420, 1974.Crossref 3. Schuhmann RE, Geddes LA, Hoff HF: Prolonged left ventricular bypass by transvalvular aortic catheterization: Physiologic effects and rationale of surgical concept . Surgery 67:957-968, 1970. 4. Hill JD, O'Brien TG, Murray JJ, etal: Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome): Use of the Bramson membrane lung . N Engl J Med 286:629-634, 1972.Crossref 5. Soeter JR, Smith GT, Anema RJ, et al: Distribution of oxygenated blood in femoral and brachial artery perfusion during venoarterial bypass in primates . J Thorac Cardiovasc Surg 65:825-829, 1973. 6. Kanarek D, Zapol W, Ahluwali B, et al: Radionuclide imaging of the distribution of membrane lung perfusion , abstracted. Trans Am Soc Artif Intern Organs 3:35, 1974. 7. Zimberg YH, Lynch CG: Controlled operative atelectasis . Ann Thorac Surg 5:325-332, 1968.Crossref 8. Corso PJ, Geelhoed GW, Joseph WL: Membrane lung oxygenation for temporary support of the failing transplanted lung . Trans Am Soc Artif Intern Organs 19:525-528, 1973.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Jan 1, 1975

References