24-hour extracorporeal membrane oxygenation in the hypoxic dog: hemodynamics and pulmonary gas exchange

Peripheral circulatory effects of pump perfusion on cat skeletal muscle with and without prostacyclin

The present study analyses the peripheral circulatory effects of pump perfusion on a sympathectomized cat skeletal muscle in terms of effects on segmental vascular resistances (large-bore arterial vessels, arterioles and veins), hydrostatic capillary pressure, capillary filtration coefficient, transcapillary filtration and autoregulation of blood flow. The effect of prostacyclin during pump perfusion was analysed to evaluate whether it interferes with the pump-induced vascular alterations, especially if it reduces transcapillary filtration through its capillary permeability decreasing effect. Pump perfusion initiates a marked vasodilation (from 17.3 to 10.1 PRU), an increase in hydrostatic capillary pressure, and a marked inhibition of myogenic reactivity and of autoregulation of blood flow. There was a slow restoration of vascular tone reaching a steady-state level somewhat below the autoperfusion value within 2 h. Pump perfusion did not change the capillary filtration coefficient, indicating that the capillary permeability was not increased. This implies that short-term pump-induced capillary leakage is more an effect of increase in hydrostatic capillary pressure, perhaps in combination with increased number of open capillaries, than of an increase in capillary permeability. Prostacyclin decreased capillary permeability by at least 22% but simultaneously increased hydrostatic capillary pressure, resulting in an unchanged filtration compared with the situation just after the starting of the pump. The results obtained show that experiments using pump perfusion should be interpreted with care due to the interference with normal peripheral vascular control. The results give reasonable explanations of the lowered blood pressure and transcapillary fluid loss during the clinical use of a heart-lung machine.