A comparison study of pulsatile and nonpulsatile circulation in renal and skin microcirculation: after cardiogenic shock

Abstract

We performed a comparative study to evaluate effects of pulsatile and nonpulsatile circulation on renal and skin microcirculation after cardiogenic shock in pigs. Cardiogenic shock model was made by ligating the left anterior descending branch. After fibrillation, biventricular assist devise were initiated. In pulsatile circulation group (Group P: 5 cases), Nippon Zeon pneumatic VAD was used for left heart, while Nikkiso centrifugal Pump HPM-15 for right heart. In nonpulsatile circulation group (Group NP: 5 cases), both left and right heart were supported by Nikkiso centrifugal pump HPM-15. Renal cortical blood flow and skin blood flow showed significantly higher in Group P than Group NP. Renal cortical blood flow/renal (cortex+medulla) blood flow also demonstrated improvement tendency in Group P compared with Group NP. LIP ratio was increased after 2h assist in Group P. These results suggest that a certain pulsetility may be necessary to maintain microcirculation and function of kidney after cardiogenic shock.