Comparison of perfusion modes on microcirculation during acute and chronic cardiac support: Is there a difference?

Bingyang Ji, Akif Undar

Research output: Contribution to journalReview articlepeer-review

35 Scopus citations

Abstract

Although heart-lung machines and cardiac assist devices have been used successfully for acute and chronic cardiac support for decades, controversies still remain concerning the benefits of pulsatile and non-pulsatile perfusion. The core of the debate is whether enough energy is generated by the artificial pulse to keep capillary beds open and cell metabolism stabilized during acute or chronic cardiac support. In other words, does artificial pulsatility exist in the microcirculation: small vessels of less than 100 μm in diameter? Many investigators have tried to use different tools and biomarkers to reflect directly or indirectly the state of the microcirculation when comparing the two different perfusion modes during acute and chronic cardiac support. However, the results are controversial. First, direct observation of the state of the microcirculation during acute and chronic cardiac support is limited; and reports concerning direct observation of the microcirculation with different perfusion modes in contemporary literature are rare. Secondly, different investigators have used their own criteria to define pulsatile flow. Therefore, it is necessary to develop more efficient methodologies, enabling direct observation of the microcirculation during acute and chronic cardiac support and also establish common criteria that will precisely quantify the pulsatile flow in terms of energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE) levels. Using these critical parameters may explain how excess energy is created by pulsatile flow and maintains perfusion through the microcirculation by ensuring capillary patency.

Original languageEnglish (US)
Pages (from-to)115-119
Number of pages5
JournalPerfusion
Volume22
Issue number2
DOIs
StatePublished - Aug 3 2007

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Safety Research
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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