Anthropometry, Body Surface Area and Cardiopulmonary Bypass: Determining the Pump Flow Rate of the Heart–Lung Machine Using Body Size

2012 ◽  
pp. 2155-2170
Author(s):  
R. Peter Alston
Keyword(s):  
Body Size ◽  
Cardiopulmonary Bypass ◽  
Surface Area ◽  
Body Surface Area ◽  
Flow Rate ◽  
Body Surface ◽  
Pump Flow ◽  
Pump Flow Rate ◽  
Heart Lung Machine ◽  
Lung Machine

Is body surface area still the best way to determine pump flow rate during cardiopulmonary bypass?

Perfusion ◽  
2006 ◽  
Vol 21 (3) ◽  
pp. 139-147 ◽  
Author(s):  
R Peter Alston ◽  
Anna Anderson ◽  
Keith Sanger
Keyword(s):  
Body Mass Index ◽  
Surface Area ◽  
Body Surface Area ◽  
Lean Body Mass ◽  
Body Mass ◽  
Flow Rate ◽  
Body Surface ◽  
Pump Flow ◽  
Pump Flow Rate ◽  
Mixed Venous

For over four decades, pump flow rate during cardio-pulmonary bypass (CPB) has been estimated using body surface area (BSA). As patients presenting for heart surgery are increasingly obese, this approach may no longer be appropriate and other estimates of systemic metabolism should be used, such as body mass index and lean body mass. Mixed venous oxygen saturation (SvO2) is a robust and independent estimate of the global efficacy of CPB. The aim of this study was to determine which factors, including body surface area, body mass index and lean body mass, best predict SvO2 during CPB. Forty-eight patients undergoing elective cardiac surgery requiring CPB were studied. Patients’ height, weight and skinfold thickness at four sites (biceps, triceps, subscapularis and suprailiac) were measured. Body surface area, lean body mass and body mass index were then calculated. Pump flow rate was maintained at 2.4 L/min/m2 during CPB as per standard unit protocol. Arterial and mixed venous blood samples were taken during the cooling, stable hypothermia and rewarming phases of CPB. Nasopharyngeal temperatures and flow rates were recorded contemporaneously. The blood samples were analysed for oxygen saturation, haemoglobin concentration and partial pressures of oxygen and carbon dioxide. The values of the three time points were meaned. All potential predictor variables were then univariately correlated with mixed venous oxygen saturation (SvO2). Those correlating significantly ( p < 0.1) were entered into a multivariate linear regression model. Nasopharyngeal temperature (β=0.615, p < 0.001) and lean body mass (β=0.256, p < 0.028) were the only significant predictors of SvO2 ( r2= 0.433, p < 0.001). Pump flow rates maintained at 2.4 L/min/m2 throughout CPB results in relative over-perfusion during hypothermia. Lean body mass may be a more sensitive estimate of systemic metabolism and, therefore, may provide a more accurate means of determining pump flow rate than body surface area in patients undergoing heart surgery.

Non heart beating donors porcine livers: effect of three different pump flow rate during cardiopulmonary bypass

2007 ◽  
Vol 24 (Supplement 39) ◽  
pp. 53
Author(s):  
R. Valero ◽  
P. Santos-Cidón ◽  
M. Net ◽  
L I. Capdevila ◽  
J C. García-Valdecasas
Keyword(s):  
Cardiopulmonary Bypass ◽  
Flow Rate ◽  
Pump Flow ◽  
Heart Beating ◽  
Pump Flow Rate

Effects of Pump Flow Rate on Oxygen Use During Moderate Hypothermic Cardiopulmonary Bypass

ASAIO Journal ◽  
1993 ◽  
Vol 39 (2) ◽  
pp. 126-131
Author(s):  
Ryuji Tominaga ◽  
Kazuhiro Kurisu ◽  
Fumio Fukumura ◽  
Atsuhiro Nakashima ◽  
Manabu Hisahara ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Flow Rate ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Pump Flow ◽  
Pump Flow Rate

A1107 CEREBRAL BLOOD FLOW AND METABOLISM ARE INDEPENDENT OF PUMP FLOW RATE DURING HYPOTHERMIC CARDIOPULMONARY BYPASS IN CHILDREN

1990 ◽  
Vol 73 (3A) ◽  
pp. NA-NA
Author(s):  
F H Kem ◽  
W J Greeley ◽  
R M Ungerleider ◽  
T J Quill ◽  
B. Baldwin ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cardiopulmonary Bypass ◽  
Flow Rate ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Pump Flow ◽  
Pump Flow Rate

scholarly journals Increased mortality in women: sex differences in burn outcomes

2017 ◽  
Vol 5 ◽  
Author(s):  
Karen Karimi ◽  
Iris Faraklas ◽  
Giavonni Lewis ◽  
Daniel Ha ◽  
Bridget Walker ◽  
...  
Keyword(s):  
Sex Differences ◽  
Body Size ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface ◽  
Thermal Injury ◽  
Inhalation Injury ◽  
Inpatient Mortality ◽  
Burn Centers ◽  
Significant Difference

Abstract Background There is increasing evidence that sex differences may influence responses after thermal injury and affect clinical outcomes. The objective of this study was to evaluate the relationships between sex, thermal injury, body size, and inpatient mortality in burn patients. Methods Medical records of adults with &gt;20% total body surface area (TBSA) burn injury admitted to two American Burn Association (ABA)-verified burn centers between 2008 and 2014 were retrospectively reviewed. Injury details and baseline characteristics, including body size as estimated by body surface area (BSA) and body mass index (BMI) were recorded, along with details of the hospital course. The primary outcome of inpatient mortality was compared between sexes. Results Out of 334 subjects, 60 were women (18%). Median TBSA was 33% (IQR 25–49) in this cohort, with 19% full thickness burns and 30% inhalation injury. Despite no significant difference in age, presence of inhalation injury, TBSA, or depth of burn, women had significantly higher rates of inpatient mortality (45 vs. 29%, P = 0.01). BSA was significantly lower in women vs. men (P &lt; 0.001), but this difference was not more pronounced among non-survivors. There was no difference in BMI between men and women non-survivors. Although not significant (P = 0.28), women succumbed to their injuries sooner than men (day 4 vs. 10 post-injury). Conclusions Women are less likely to survive burn injuries and die sooner than men with similar injuries. Body size does not appear to modulate this effect. Burn centers should be aware of the higher mortality risk in women with large burns.

The effect of normothermic cardiopulmonary bypass on hepatic blood flow in the dog

Perfusion ◽  
1986 ◽  
Vol 1 (4) ◽  
pp. 245-253 ◽  
Author(s):  
RT Mathie ◽  
JB Desai ◽  
KM Taylor
Keyword(s):  
Blood Flow ◽  
Cardiopulmonary Bypass ◽  
Vascular Resistance ◽  
Flow Rate ◽  
Hepatic Blood Flow ◽  
Liver Blood Flow ◽  
Relative Reduction ◽  
Blood Flows ◽  
Pump Flow ◽  
Pump Flow Rate

Hepatic blood flow was investigated in two groups of eight anaesthetized dogs during and after one hour of either pulsatile or non-pulsatile cardiopulmonary bypass (CPB). Mean perfusion pressure was maintained at 60 mmHg. Hepatic arterial (HA) and portal venous (PV) blood flows were measured using electromagnetic flow probes, and hepatic O 2 consumption determined. The results demonstrate that: (a) pulsatile CPB reduces peripheral vascular resistance during and after perfusion, and more effectively preserves pump flow rate and cardiac output than non-pulsatile CPB; (b) total liver blood flow is sustained more effectively by pulsatile CPB than by non-pulsatile CPB due to relative preservation of both HA and PV flows; (c) hepatic O2 consumption is only marginally better preserved during and after pulsatile CPB than with non-pulsatile perfusion. We conclude that: (a) pulsatile CPB tends to maintain hepatic blood flow through a relative reduction in HA vascular resistance and an improvement in PV flow produced passively by a greater pump flow rate; (b) pulsatile CPB less effectively benefits hepatic O2 consumption because of poor O2 uptake from the hepatic PV blood supply.

Determination of Pump Flow Rate During Cardiopulmonary Bypass in Obese Patients Avoiding Hemodilution

2009 ◽  
Vol 24 (3) ◽  
pp. 245-249 ◽  
Author(s):  
Luisa Santambrogio ◽  
Cristian Leva ◽  
Giorgio Musazzi ◽  
Piergiorgio Bruno ◽  
Andrea Vailati ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Flow Rate ◽  
Obese Patients ◽  
Pump Flow ◽  
Pump Flow Rate

Effect of pump flow rate on cerebral blood flow during hypothermic cardiopulmonary bypass in adults

1997 ◽  
Vol 11 (4) ◽  
pp. 415-419 ◽  
Author(s):  
David J. Cook ◽  
Jacqueline A. Proper ◽  
Thomas A. Orszulak ◽  
Richard C. Daly ◽  
William C. Oliver
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cardiopulmonary Bypass ◽  
Flow Rate ◽  
Hypothermic Cardiopulmonary Bypass ◽  
Pump Flow ◽  
Pump Flow Rate

Should blood flow during cardiopulmonary bypass be individualized more than to body surface area?

Perfusion ◽  
2010 ◽  
Vol 26 (1) ◽  
pp. 45-50 ◽  
Author(s):  
SA Thomassen ◽  
A. Larsson ◽  
JJ Andreasen ◽  
W. Bundgaard ◽  
M. Boegsted ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cardiopulmonary Bypass ◽  
Surface Area ◽  
Body Surface Area ◽  
Body Surface
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