J.Jpn. Surg. Soc.. 57(8): 1329-1347, 1956

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STUDIES ON THE MECHANICAL HEART AND LUNG, ESPECIALLY ON THE CHANGES OF BLOOD INGREDIENTS AND BLOOD PRESSURE THROUGH EXTRACORPOREAL CIRCULATION

Since 1951 experiments of the mechanical heart and lung have been performed in our laboratory, and three pumps of Dale-Schuster type and two types of oxygenators have been produced. From April 1953 to March 1954, 38 experiments were performed with Vanton pump as a heart; 19 of which were the attempts to empty the left side of heart and 19 to empty the right side of the heart. Four long survivals of the left heart experiments and 5 of the right were obtained. The author investigated the changes of some blood ingredients and blood pressure in these experiments.
White blood cells and platelets severely decreased in number immediately after start of the extracorporeal circulation, being restored to normal counts in about 5 hours after the circulation end. White blood cell counts increased afterwards to 3 to 4 times as normal, and settled down to normal in 4 or 5 weeks. The neutrophiles were the leading player in these changes. Red blood cell counts also decreased through the extracorporeal circulation and came back to normal in about 4 weeks without intermediate ascent as white blood cell counts. The decreasing of platelet counts after the circulation must have to de with the remaining of prolonged bleeding times which generally could not be restored in spite of the infusion of an adequate amount of protamine to neutralise fully the amount of heparin injected before the circulation, while the prolonged blood clotting times easily returned to normal by the infusion of protamine.
As for hemolysis, 80 to 200 mg% of hemoglobin was found in plasma after the end of about 30 minutes of extracorporeal circulations of our experiments and disappeared in 48 hours after the circulation.
Lactic acid and pyruvic acid increased a little during the extracorporeal circulation, and came back to normal in 24 hours.
Blood pH descended until 7.1 to 7.2 during the circulation in some cases, but soon (1 or 2 hour later) returned to normal.
The arterial blood oxygen contents unexpectedly decreased, when some fluid other than pure blood was inevitably mingled in the extracorporeal circuit, or when too much physiological saline solution was infused into an animal with protamine which fairly lowers blood pressure when used in a high concentration. The decreased oxygen contents would not be restored in a few days.
Those with unstable arterial blood pressure during the experiment were of bad prognosis.
Venous pressure increased during the circulation in every case. At the same time the niveau of the blood in blood preservoir gradually descended. It seems to indicate that the pooling of blood occurs in animal's body little by little during the circulation.
The prognosis of those cases in which venous pressure continued to be high until long after the operation was generally unfavorable.
(author's abstract)

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