Curtis J J, Walls J T, Wagner-Mann C C, Schmaltz R A, Demmy T L, McKenney C A, Mann F A
Division of Cardiothoracic Surgery, University of Missouri School of Medicine, Columbia, USA.
Ann Thorac Surg. 1999 Aug;68(2):666-71. doi: 10.1016/s0003-4975(99)00583-4.
Because of simplicity of application, universal access, and low cost, centrifugal pumps are commonly used for short-term mechanical cardiac assist. Indications and techniques for application of this technology continue to evolve.
The clinical experience with 151 patients undergoing centrifugal mechanical cardiac assist at the University of Missouri-Columbia has been reviewed. We have compared commonly available centrifugal pumping systems in vitro and in vivo for characteristics that might distinguish them.
Centrifugal pumps have been found to be well suited for use in surgery on the thoracic aorta, for extracorporeal membrane oxygenation and for postcardiotomy cardiac mechanical assist. Complications associated with centrifugal mechanical assist are predictable and common but potentially can be reduced by improved surgical techniques and anticoagulation strategies. In vitro and in vivo experimentation with available centrifugal pumps reveals nuances characteristic of each of the devices.
All centrifugal pumps presently available are less destructive to blood cellular elements compared with roller pumps. With familiarity, all can function satisfactorily for short-term mechanical assist with no compelling evidence that favors any particular centrifugal pump system clinically available. Centrifugal pumps are ideally suited for left heart bypass during surgery on a thoracic aorta and for short-term application as may be required for postcardiotomy mechanical assist. Centrifugal pump technology should be part of the armamentarium of all cardiothoracic surgeons.
由于应用简便、易于普及且成本低廉，离心泵常用于短期心脏机械辅助。该技术的应用指征和方法仍在不断发展。
回顾了密苏里大学哥伦比亚分校151例接受离心式心脏机械辅助患者的临床经验。我们对常用的离心泵系统进行了体外和体内比较，以找出可能区分它们的特性。
已发现离心泵非常适合用于胸主动脉手术、体外膜肺氧合及心脏术后心脏机械辅助。与离心式机械辅助相关的并发症是可预测且常见的，但通过改进手术技术和抗凝策略可能会降低。对现有离心泵进行的体外和体内实验揭示了每种设备的细微特性。
与滚压泵相比，目前所有的离心泵对血细胞成分的破坏都较小。熟悉后，所有离心泵都能在短期机械辅助中发挥令人满意的作用，没有令人信服的证据表明临床上更青睐任何一种特定的离心泵系统。离心泵非常适合在胸主动脉手术期间进行左心旁路，以及在心脏术后机械辅助可能需要时进行短期应用。离心泵技术应成为所有心胸外科医生的装备之一。
