Radial artery-to-aorta pressure difference after discontinuation of cardiopulmonary bypass

• Published in: Anesthesiology (Philadelphia) Vol. 70; no. 6; pp. 935 - 941
• Main Authors: PAUCA, A. L, HUDSPETH, A. S, WALLENHAUPT, S. L, TUCKER, W. Y, KON, N. D, MILLS, S. A, CORDELL, A
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott 01.06.1989
• Subjects: Aged; Anesthesia; Anesthesia depending on type of surgery; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Aorta - physiology; Arteries - physiology; Biological and medical sciences; Blood Pressure; Cardiopulmonary Bypass; Female; Hand - blood supply; Humans; Male; Medical sciences; Middle Aged; Thoracic and cardiovascular surgery. Cardiopulmonary bypass; Vascular Resistance; Cardiopulmonary bypass; Human; General anesthesia; Arterial pressure; Hemodynamics
• ISSN: 0003-3022; 1528-1175
• DOI: 10.1097/00000542-198906000-00009

To test whether the radial artery-to-aorta pressure gradient seen in some patients after cardiopulmonary bypass (CPB) is due to reduction in hand vascular resistance, the authors compared pressures in the ascending aorta with pressures in the radial artery before and after CPB in 12 patients. They increased hand vascular resistance by briefly occluding the radial and ulnar arteries at the wrist and recorded that effect on the radial artery-to-aorta pressure relationship. They also recorded the effect of wrist compression on radial artery pressures before and after CPB in 38 patients not having aortic pressure measurements. Before CPB in the first 12 patients, the radial systolic arterial pressure (SAP) was significantly higher (P less than 0.05) than the ascending aortic SAP, and wrist compression did not significantly affect that difference (P greater than 0.05). After CPB, the radial artery and aortic SAPs were not statistically different (P greater than 0.05), but wrist compression restored the higher radial artery SAP. The mean arterial pressure (MAP) was equal in four patients and 1-3 mmHg higher or lower in eight patients before CPB, and wrist compression did not alter those relationships. After CPB, MAP was equal in four patients; radial MAP was 1-3 mmHg higher or lower in six patients, and 7 and 10 mmHg lower in the last two patients.