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2. Pulmonary and Systemic Vascular Resistances After Cardiopulmonary Bypass: Role of Hemolysis

Author

Kenneth Shelton, Fumito Ichinose, Nathalie Roy, Liu Chen, Warren M. Zapol, Lorenzo Berra, Edward A. Bittner, Emanuele Rezoagli, Daniel Bloch, Sabrina Strelow, Rui Matsumine, Rezoagli, E, Ichinose, F, Strelow, S, Roy, N, Shelton, K, Matsumine, R, Chen, L, Bittner, E, Bloch, D, Zapol, W, and Berra, L

Subjects
plasma hemoglobin, Male, medicine.medical_specialty, Hemolysi, systemic vascular resistance, 030204 cardiovascular system & hematology, Hemolysis, Nitric oxide, law.invention, Cohort Studies, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Postoperative Complications, law, nitric oxide, Cardiopulmonary bypass, Medicine, Humans, Prospective Studies, Prospective cohort study, Aged, Cardiopulmonary Bypass, business.industry, Cardiopulmonary Bypa, Middle Aged, medicine.disease, Cardiac surgery, Prospective Studie, surgical procedures, operative, Anesthesiology and Pain Medicine, medicine.anatomical_structure, 030228 respiratory system, chemistry, Anesthesia, Concomitant, pulmonary vascular resistance, Vascular resistance, Female, Vascular Resistance, Postoperative Complication, medicine.symptom, Cohort Studie, Cardiology and Cardiovascular Medicine, business, Vasoconstriction, circulatory and respiratory physiology, Human
Abstract

Objectives Prolonged cardiopulmonary bypass (CPB) is associated with hemolysis, resulting in increased plasma oxyhemoglobin and vascular nitric oxide depletion. The authors hypothesized that hemolysis associated with CPB would reduce nitric oxide bioavailability, resulting in high pulmonary and systemic vascular resistances that after CPB would normalize gradually over time, due to clearance of plasma oxyhemoglobin. The authors also investigated whether prolonged CPB (≥140 min) produced increased levels of hemolysis and greater pulmonary and systemic vasoconstriction. Design Prospective cohort study. Setting Single-center university hospital. Patients The study comprised 50 patients undergoing elective cardiac surgery requiring CPB. Interventions Plasma hemoglobin and plasma nitric oxide consumption were measured before surgery and after CPB. Pulmonary and systemic hemodynamics were measured after CPB. The effects of short (

Published
2017

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