Différences microcirculatoires entre CEC pulsée et non pulsée

The benefit of pulsatile cardiopulmonary bypass (CPB) is still open for debate. Beyond the difficulties to quantify pulsatility during CPB, the lack of evidence of the pulsatile effect on the microcirculation has widely contributed to this controversy. Intravital microscopy has demonstrated in the 90's that pulsatility exists in the capillary bed. Pulsatile perfusion provides energy equivalent pressure and transmission of surplus hemodynamic energy to the tissues ensuring exchanges between vascular and extra-vascular compartments. Thus cellular metabolism is improved as reflected by numerous physiologic and biochemical markers.