Effect of pulsatilite versus nonpulsatile perfusion on lactate levels during cardiopulmonary bypass

Cardiopulmonary bypass is known to negatively effect many systems. Researches and discussions are still ongoing on how the perfusion pattern should be to minimize these negative effects, and the superiority of pulsatile and nonpulsatile flows over each other. It is thought that because the pulsatile flow is closer to the flow provided by the heartbeat, it positively affects the serum lactate level. In our study, we aimed to show which flow pattern can lead to better results by comparing the effect of pulsatile and nonpulsatile flow on serum lactate level. In our study, the data of adult patients who underwent cardiopulmonary bypass between January 01, 2013 and December 31, 2016 in the Cardiovascular Surgery clinic of Dokuz Eylul Hospital will be retrospectively reviewed. GROUP1: 30 patients with pulsatile flow in cardiopulmonary bypass GROUP2: 30 patients with nonpulsatile flow in cardiopulmonary bypass In this study, cases with a cardiopulmonary bypass (CPB) duration exceeding 3 hours, with diabetes, kidney failure, infection, without aortic cross clamp (AKK) and emergency cases were not included. Preoperative, during CPB, 30.-60.-90. minutes, after CPB , admission to intensive care, postoperative 4.-8.-12.-24. hour hematocrit (Hct), lactate (lct), partial hyrogen (pH), and partial oxygen (PO2) levels of patients were scanned and analyzed. As a result of our study, it was concluded that pulsatile and non-pulsatile flow patterns applied in CPB do not have any superiority over serum lactate, Htc, PO2, pH, length of stay in intensive care and extubation time. Key Words : Cardiopulmonary bypass , extracorporeal circulation, open heart surgery , hyperlactathemia , pulsatile flow, nonpulsatile flow