Hypothermic Low-Flow Cardiopulmonary Bypass Impairs Pulmonary and Right Ventricular Function More Than Circulatory Arrest Jess M. Schultz, MD, Tara Karamlou,

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Hypothermic Low-Flow Cardiopulmonary Bypass Impairs Pulmonary and Right Ventricular Function More Than Circulatory Arrest Jess M. Schultz, MD, Tara Karamlou, MD, Julia Swanson, BA, Irving Shen, MD, Ross M. Ungerleider, MD The Annals of Thoracic Surgery Volume 81, Issue 2, Pages 474-480 (February 2006) DOI: 10.1016/j.athoracsur.2005.06.041 Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Exposure time to cardiopulmonary bypass stratified according to cooling, experimental period, rewarming, and total time. Total minutes of exposure to cardiopulmonary bypass was higher in the hypothermic low-flow (HLF) group (open bars [170.0 ± 15.5 minutes]), as compared with the hypothermic circulatory arrest (HCA) group (solid bars [95.0 ± 10.5 minutes; p < 0.001]). However, cardiopulmonary bypass exposure time for the HCA group and the HCF group were similar during cooling (46.7 ± 5.4 minutes and 41.4 ± 5.0 minutes, respectively) and rewarming (63.3 ± 8.7 minutes and 53.6 ± 6.6 minutes, respectively). The Annals of Thoracic Surgery 2006 81, 474-480DOI: (10.1016/j.athoracsur.2005.06.041) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Serum tumor necrosis factor-alpha (TNF-α) concentration at baseline, before rewarming, and before weaning from cardiopulmonary bypass. Serum TNF-α concentration was higher at the end of rewarming in the hypothermic low-flow (HLF) group (squares [2990.5 ± 884.5 pg/mL]) when compared with the hypothermic circulatory arrest (HCA) group (diamonds [374.6 ± 89.2 pg/mL; p = 0.02]). Additionally, the serum TNF-α concentration of the HLF group after cardiopulmonary bypass (post-CPB) was higher than the concentration at both baseline (164 ± 47.1 pg/mL), and at the start of rewarming (1080.0 ± 508.4 pg/mL; p = 0.03, and p = 0.02, respectively). Within the HCA group, no difference in serum TNF-α concentration could be detected between baseline (172.3 ± 54.6 pg/mL), the start of rewarming (318.9 ± 156.9 pg/mL), or the end of rewarming (374.6 ± 89.2 pg/mL). The Annals of Thoracic Surgery 2006 81, 474-480DOI: (10.1016/j.athoracsur.2005.06.041) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions