Nakata K I, Yoshikawa M, Takano T, Sankai Y, Ohtsuka G, Glueck J, Fujisawa A, Makinouchi K, Yokokawa M, Nosaka S, Nose Y
Department of Surgery, Baylor College of Medicine, One Baylor Plaza, Houston, Texas 77030, USA.
Ann Thorac Cardiovasc Surg. 2000 Aug;6(4):242-6.
Rotary blood pumps can be used for long-term left ventricular assist devices. These pumps have several advantages over the conventional pulsatile pumps including smaller size, higher efficiency, and simple design and construction. However, one of the difficulties associated with the rotary blood pump is the proper control method to maintain an optimum flow rate in different physiological conditions. The rotary blood pump can be controlled by two methods. The first is to utilize the measured pump flow rate from its servo signal. The second is to detect and avoid abnormal pumping conditions such as; back flow and sudden increase in the pressure head. This abnormal situation typically occurs from excessive suction of blood when there is a functional or mechanical occlusion in the inflow cannula. The ultrasound flow meter is durable and reliable but it is difficult to continually monitor the blood flow rate of an implantable pump. Therefore, another method is needed instead of the continuous flow monitoring. One chronic calf having an LVAD was subjected for the development of this control system. This calf survived more than 6 months. Voltage, current, motor speed, heart rate and the pump flow rate were recorded and stored at 30-min intervals in a computer. Utilizing these parameters, attempts were made (1) to achieve indirect flow assessments and (2) to reveal abnormal operating parameters of the centrifugal pump (1). Indirect flow measurement, the predicted pump flow rate was calculated from these pump derived parameters (required power, motor speed and heart rate). The value of the coefficient of determination (R) between the measured and estimated pump flow rate was 0.796. (2) Abnormal operating indicator, there was an association between the required current and pump flow waves. The current was differentiated, and then calculated to the power of the differentiated current. The normal range of this value was 0.02+/-0.54. In abnormal conditions, this abnormal operating indicator increased 500 times. The predicted flow estimation method and abnormal operating indicator were available from intrinsic operating parameters of the pump and need no sensors. These two methods were simple, yet they are possibly effective and reliable servo control methods for a rotary blood pump.
旋转血泵可用于长期左心室辅助装置。与传统的搏动泵相比,这些泵具有几个优点,包括尺寸更小、效率更高以及设计和结构简单。然而,与旋转血泵相关的困难之一是在不同生理条件下维持最佳流速的适当控制方法。旋转血泵可以通过两种方法进行控制。第一种是利用从其伺服信号测量的泵流速。第二种是检测并避免异常泵送情况,例如回流和压头突然增加。这种异常情况通常发生在流入插管存在功能或机械阻塞时血液过度抽吸的情况下。超声流量计耐用且可靠,但难以持续监测植入式泵的血流速度。因此,需要另一种方法来代替连续流量监测。一头植入左心室辅助装置的慢性小牛被用于该控制系统的开发。这头小牛存活了6个多月。电压、电流、电机转速、心率和泵流速每隔30分钟记录并存储在计算机中。利用这些参数,试图(1)实现间接流量评估,(2)揭示离心泵的异常运行参数(1)。间接流量测量,根据这些泵衍生参数(所需功率、电机转速和心率)计算预测的泵流速。测量的和估计的泵流速之间的决定系数(R)值为0.796。(2)异常运行指标,所需电流和泵流波之间存在关联。对电流进行微分,然后计算微分电流的幂。该值的正常范围是0.02±0.54。在异常情况下,这个异常运行指标增加了500倍。预测流量估计方法和异常运行指标可从泵的固有运行参数获得,无需传感器。这两种方法很简单,但它们可能是旋转血泵有效且可靠的伺服控制方法。