The Journal of Thoracic and Cardiovascular Surgery
Volume 134, Issue 3 , Pages 587-593 , September 2007

Elevated flow rate during cardiopulmonary bypass is associated with fluid accumulation

  • Oddbjørn Haugen, MD

      Affiliations

    • Department of Anesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway
    • ,
  • Marit Farstad, MD, PhD

      Affiliations

    • Surgical Research Laboratory, Department of Surgical Sciences, University of Bergen, Bergen, Norway
    • ,
  • Venny Kvalheim, MD

      Affiliations

    • Section for Thoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
    • ,
  • Olav Bøe, DDS, MSc

      Affiliations

    • Department of Oral Science, Dental Research, University of Bergen, Bergen, Norway.
    • ,
  • Paul Husby, MD, PhD

      Affiliations

    • Surgical Research Laboratory, Department of Surgical Sciences, University of Bergen, Bergen, Norway
    • Corresponding Author InformationAddress for reprints: Paul Husby, MD, PhD, Professor, Department of Surgical Sciences, University of Bergen, Haukeland University Hospital, N-5021 Bergen/Norway. Phone: (+47) 55 97 68 50 (secretary) Fax: (+47) 55 97 68 98.

Received 13 February 2007 ,Revised 29 March 2007 ,Accepted 26 April 2007.

References 

  1. Toraman F, Evrenkaya S, Yuce M, Turek O, Aksoy N, Karabulut H, et al. Highly positive intraoperative fluid balance during cardiac surgery is associated with adverse outcome. Perfusion. 2004;19:85–91
  2. Schroth M, Plank C, Meißner U, Eberle K-P, Weyand M, Cesnjevar R, et al. Hypertonic-hyperoncotic solutions improve cardiac function in children after open-heart surgery. Pediatrics. 2006;118:e76–e84
  3. Luciani GB, Menon T, Vecchi B, Auriemma S, Mazzucco A. Modified ultrafiltration reduces morbidity after adult cardiac operations. Circulation. 2001;104(Suppl I):I253–I259
  4. Farstad M, Heltne JK, Rynning SE, Lund T, Mongstad A, Eliassen F, et al. Fluid extravasation during cardiopulmonary bypass in piglets—effects of hypothermia and different cooling protocols. Acta Anaesthesiol Scand. 2003;47:397–406
  5. Farstad M, Kvalheim VL, Husby P. Cold-induced fluid extravasation during cardiopulmonary bypass in piglets can be counteracted by use of iso-oncotic prime. J Thorac Cardiovasc Surg. 2005;130:287–294
  6. Farstad M, Heltne JK, Rynning SE, Onarheim H, Mongstad A, Eliassen F, et al. Can the use of methylprednisolon, vitamin C, or α-trinositol prevent cold-induced fluid extravasation during cardiopulmonary bypass in piglets?. J Thorac Cardiovasc Surg. 2004;127:525–534
  7. Husby P, Heltne JK, Koller ME, Birkeland S, Westby J, Fosse R, et al. Midazolam-fentanyl-isoflurane anaesthesia is suitable for haemodynamic and fluid balance studies in pigs. Lab Anim. 1998;32:316–323
  8. Haugen O, Farstad M, Kvalheim VL, Rynning SE, Hammersborg S, Mongstad A, et al. Mean arterial pressure about 40 mmHg during CPB is associated with cerebral ischemia in piglets. Scand Cardiovasc J. 2006;40:54–61
  9. Heltne JK, Husby P, Koller ME, Lund T. Sampling of interstitial fluid and measurement of colloid osmotic pressure (COPi) in pigs: evaluation of the Wick method. Lab Anim. 1998;32:439–445
  10. Heltne JK, Farstad M, Lund T, Koller ME, Matre K, Rynning SE, et al. Determination of plasma volume in anesthetized piglets using the carbon monoxide (CO) method. Lab Anim. 2002;36:344–350
  11. Hawk CT, Leary SL. Formulatory for laboratory animals. In: Iowa State Pr (Sd): American College for Laboratory Animal Medicine; 1995;p. 78
  12. O’Dwyer C, Woodson LC, Conroy BP, Lin CY, Deyo DJ, Uchida T, et al. Regional perfusion abnormalities with phenylephrine during normothermic bypass. Ann Thorac Surg. 1997;63:728–735
  13. Plochl W, Orszulak TA, Cook DJ, Sarpal RS, Dickerman DL. Support of mean arterial pressure during tepid cardiopulmonary bypass: effects of phenylephrine and pump flow on systemic oxygen supply and demand. J Cardiothorac Vasc Anesth. 1999;13:441–445
  14. DiNardo JA, Wegner JA. Pro: low-flow cardiopulmonary bypass is the preferred technique for patients undergoing cardiac surgical procedures. J Cardiothorac Vasc Anesth. 2001;15:649–651
  15. Lehot JJ, Villard J, Piriz H, Philbin DM, Carry PY, Gauquelin G, et al. Hemodynamic and hormonal responses to hypothermic and normothermic cardiopulmonary bypass. J Cardiothorac Vasc Anesth. 1992;6:132–139
  16. Brancaccio G, Michielon G, Di Donato RM, Costa D, Falzea F, Miraldi F. Atrial natriuretic factor in normothermic and hypothermic cardiopulmonary bypass. Perfusion. 2004;19:157–162
  17. Starling EH. On the absorbtion of fluids from the connective tissue spaces. J Physiol. 1896;19:312–326
  18. Maspers M, Björnberg J, Mellander S. Relation between capillary pressure and vascular tone over the range from maximum dilatation to maximum constriction in cat skeletal muscle. Acta Physiol Scand. 1990;140:73–83
  19. Levick JR. Circulation of fluid between plasma, interstitium and lymph. In:  Levick JR editors. An introduction to cardiovascular physiology. 4th ed.. London: Arnold; 2003;p. 171–198
  20. Rein KA, Stenseth R, Myhre HO, Levang OW, Kahn S. Time-related changes in the Starling forces following extracorporeal circulation. Cardiovasc Drugs Ther. 1988;2:561–568
  21. Menninger FJ, Rosenkranz ER, Utley JR, Dembitsky WP, Hargens AR, Peters RM. Interstitial hydrostatic pressures in patients undergoing CABG and valve replacement. J Thorac Cardiovasc Surg. 1980;79:181–187
  22. Hannon JP, Bossone CA, Wade CE. Normal physiological values for conscious pigs used in biomedical research. Lab Anim Sci. 1990;40:293–298
  23. Cook DDJ. Con: low-flow cardiopulmonary bypass is not the preferred technique for patients undergoing cardiac surgical procedures. J Cardiothorac Vasc Anesth. 2001;15:652–654
  24. Horan PG, Leonard N, Herity NA. Progressively increasing operative risk among patients referred for coronary artery bypass surgery. Ulster Med J. 2006;75:136–140
  25. Geissler HJ, Allen SJ. Myocardial fluid balance: pathophysiology and clinical implications. J Thorac Cardiovasc Surg. 1998;46:242–245

 This study was financially supported by The Western Norway Regional Health Authority, The Norwegian Council on Cardiovascular Diseases, Faculty of Medicine, University of Bergen, and The Frank Mohn Foundation, Norway.

PII: S0022-5223(07)00798-2

doi: 10.1016/j.jtcvs.2007.04.040

The Journal of Thoracic and Cardiovascular Surgery
Volume 134, Issue 3 , Pages 587-593 , September 2007

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