T. Watanabe et al., BLOOD CARDIOPLEGIA INFUSION USING A RECIRCULATION TYPE CIRCUIT GENERATES BRADYKININ IN SIGNIFICANT AMOUNTS DURING OPEN-HEART-SURGERY, Artificial organs, 21(10), 1997, pp. 1087-1090
The single pass type (SP) of blood cardioplegia is commonly used in No
rth America during open heart surgery. However the recirculation type
(RC) of blood cardioplegia is still widely used in other areas includi
ng Japan. Infusion blood cardioplegia using the latter technique often
decreases the perfusion pressure. To determine the cause for this, bl
ood levels of bradykinin (BK) were measured in cardiopulmonary bypass
(CPB) and the 2 types of blood cardioplegic circuits. As the BK levels
in the RC cardioplegia (>3,000 pg/ml) rose, the perfusion pressure de
creased abruptly with the increase of the BK levels in the CPB circuit
. With SP cardioplegia, the BK level was not increased either during c
ardioplegia (p < 0.009) or CPB (p < 0.009), and the perfusion pressure
was not decreased (p < 0.02). We concluded that the SP circuit is sup
erior to the RC one because of the lesser production of BK and thus le
sser fluctuation of perfusion pressure.