Total Body Perfusion in Cardiac Operations

Abstract

Extracorporeal oxygenation has distinct hazards and limitations which are inherent in the basic process of gas exchange. Clinical and laboratory studies have demonstrated that all currently available methods of oxygenation (bubbling, filming, and membrane) result in varying degrees of pathologic change in the lungs, kidneys, and brain.^2,3,6,10 In the early stages of extracorporeal circulation, undoubtably some damage to the blood occurred from suction, turbulence, and pumping, and foreign material may have been introduced in the form of pyrogens, gas bubbles, or antifoaming agents. In general, however, these sources of damage have been removed or reduced to a minimum, and they now account for a relatively small proportion of the tissue changes with which we are concerned. Alteration in the blood elements appears to occur at the gas-fluid interface. The resulting phenomena include atelectasis, fluid transudation, and intravascular agglutination of erythrocytes.¹¹ A loss of surface-active agent has also been