Cardiac Bypass Pump Flow Management via NIRS Monitoring

During cardiac surgery, bypass pumps rely on pressure monitors to evaluate flow. We studied whether it would be possible to optimize pump flow by monitoring changes in cerebral cytochrome a , a 3 using NIRS to maintain cyt redox status at its pre‐bypass level. Method : 18 healthy 7–45 kg swine were placed on bypass for repeated cycles of cooling and re‐warming from 36 to 15 to 36 ° C in 3 ° C steps. Between each cycle, the swine′s bypass pump blood flow rate was adjusted to restore cytochrome redox status to its pre‐bypass value. Results : In all swine trials, the number of pump flow alterations imposed by NIRS monitoring ranged from 0 to 42, the average being 14 per trial. The best trial had 22 pump flow adjustments during which the range of cytochrome redox status change was 0.50±0.06 μ mol l –1 . The average trial had a range of cytochrome redox status change of 1.50±0.22 μ mol l –1 . Conclusion : NIRS‐driven alterations in pump flow rate to maintain pre‐bypass cytochrome redox status can be achieved successfully in the animal model.