Balloon pump-induced pulsatile perfusion during cardiopulmonary bypass does not improve brain oxygenation

Background: Whether pulsatile flow offers substantial advantages for brain protection during cardiopulmonary bypass is controversial. The purpose of t his study is to determine whether differences exist between pulsatile and n onpulsatile bypass concerning the effects on internal jugular venous satura tion and on the state of regional cerebral oxygenation during normothermia, Methods: Twenty-two patients undergoing elective coronary artery bypass gr afting were randomly divided into 2 groups: group 1 (n = 11) received nonpu lsatile perfusion during cardiopulmonary bypass and group 2 (n = 11) receiv ed pulsatile perfusion during bypass. We used an intra-aortic balloon pump; to generate pulsatility, A spectrophotometric probe (INVOS 3100R, Somanetic s, Troy, Mich) was used to assess the state of regional cerebral oxygenatio n, A 4F fiberoptic oximetry oxygen saturation catheter was inserted into th e right jugular bulb to monitor jugular venous oxygen saturation, Hemodynam ic variables, arterial and jugular venous blood gases, and regional cerebra l oxygenation were measured at 7 times points. Results: In both groups, jug ular venous oxygen saturation decreased at the early stage of the cardiopul monary bypass (P = .03). Five patients in group 1 and 6 in group 2 had a ju gular venous oxygen saturation of less than 50%, In both groups, the region al cerebral oxygenation value decreased during cardiopulmonary bypass (P = .04). Conclusions: The present results showed that pulsatility generated th rough the use of intra-aortic balloon pumping did not produce any beneficia l effects on jugular venous oxygen saturation and regional cerebral oxygena tion at normothermia.