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J Biomed 2017; 2:20-24. doi:10.7150/jbm.17864 This volume Cite

Review

Advanced Perfusion Techniques - Flow versus Pressure

Maria D. Pappa¹, Nikolaos V. Theodosiadis¹, Dimitrios Paliouras², Thomas Rallis², Apostolos S. Gogakos², Nikolaos Barbetakis², Fotios Chatzinikolaou³, Nikolaos C. Schizas², Achilleas Lazopoulos², Paul Zarogoulidis^5✉, Nikolaos Katsikogiannis⁶, Eirini Sarika⁶, Ilias Karapantzos⁷, Charalampos Charalampidis⁸, Pavlos Sarafis⁴

1. Cardiac Surgery Department, 401 Military Hospital, Athens, Greece;
2. Thoracic Surgery Department, “Theagenio” Cancer Hospital, Thessaloniki, Greece;
3. Pathology Department, “Theagenio” Cancer Hospital, Thessaloniki, Greece;
4. Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus;
5. Pulmonary Department-Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece;
6. Surgery Department (NHS), University General Hospital of Alexandroupolis, Alexandroupolis, Greece;
7. Ear, Nose and Throat Department, “Saint Luke” Private Hospital, Panorama, Thessaloniki, Greece;
8. Department of Anatomy, Democritus University of Thrace, Alexandroupolis, Greece.

✉ Corresponding author: Paul Zarogoulidis, M.D, Ph. D. Pulmonary Department-Oncology Unit, “G. Papanikolaou” General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece. Fax: 00302310992424 Mobile: 00306977271974 E-mail: pzarogcom. More

Abstract

Cardiac operations which require Cardiopulmonary bypass (CPB) are considered the most common procedures in cardiac surgery, performed for more than half a century, especially in Europe and North America. Despite that new technologies are being incorporated in CPB as long as the development of new techniques in CPB, some debates still remain. These debates regard the achievement of the needed optimal perfusion during CPB and the relation between perfusion pressures and the optimal blood flow during extracorporeal circulation. Blood flow and blood pressure during Cardiopulmonary bypass are very important factors. Although more studies are in favor of a minor superiority of the optimal blood flow requirements, compared to the corresponding optimal blood pressure needs, their role is quite interdependent. The usage of contemporary electronic Data Management Systems (DMS) led to a significant evolution of the perfusion science. Adequate perfusion can now be judged by its results in real time, while information from DMS, such as venous saturation, levels of haemoglobin and lactate, may be used as the markers of optimal perfusion and additionally for the development of the perfusion protocols in the future.

Keywords: Cardiopulmonary bypass, blood, flow, pressure.

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