An Experimental Study on Hypothermic Cardiopulmonary Bypass with Hemodilution Technique

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Twenty-six adult mongr-1 dogs were subjected to a study on hypothermic cardiopulmonary bypass with hemodilution technique. The extracorporeal system used consisted of a rotating disc oxygenator, two roller pumps and two heat exchangers designed specially for this series of experiments. Five percent dextrose in water was the principal diluent. Saving the blood, keeping an adequate microcirculation and preventing possible homologous blood syndrome were the main purposes of hemodilution. A lowered efficiency of the oxygenator due to the reduction in size was covered by inducing hypothermic perfusion at a low flow rate, The efficiency of the heat exchanger was excellent enough to accomplish this perfusion technique satisfactorily. The model change of the heat exchanger resulted in the exclusion of the bubble trap and the reservoir from the extracorporeal system. Complete bypass was achieved at an average rectal temperature of 25.1℃ (esophageal 27.2℃) for 30 min at an average flow rate of 30ml/kg/min. The lowest hematocrit averaged 70% of the control value. Entering rewarming after complete bypass, changes in hematocrit, oxrygen content, blood pressure, EEG and ECG caused by the perfusion began to disappear progressively. The lowered pH and pC02 were thought to be corrected by using sodium bicarbonate, THAM or C02. Fifteen animals out of 26 tolerated the procedure well, and the result of the clinical application of this perfusion technique was excellent.

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