Jegger David, Corno Antonio F, Mucciolo Antonio, Mucciolo Giuseppe, Boone Yves, Horisberger Judith, Seigneul Isabelle, Jachertz Mirka, von Segesser Ludwig K
Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Perfusion. 2003 Mar;18(1):61-5. doi: 10.1191/0267659103pf640oa.
During cardiopulmonary bypass (CPB), venous drainage may be impeded due to small vessel and cannula size or chattering, thus, blood return to the heart-lung machine is reduced. We designed a self-expandable prototype cannula, which is able to maintain the vein open and overcome this problem and analysed its performance capability. This prototype and several other cannulae were tested using an access vessel diameter of 7 mm. An in vitro circuit was set up with a 10 mm penrose latex tube simulating the patient's vein placed between the patient preload reservoir and the cannula, encasing the cannula's inlet(s). Maximum flow rate was determined for passive venous drainage (PVD) at preloads (P) of 2 and 4 mmHg. We compared these results to three classic single-stage venous cannulae: basket tip, thoracic drain and percutaneous tip. By comparing the other cannulae to the prototype, under PVD conditions and a central venous pressure (CVP) of 2 mmHg, the prototype cannula's flow rate (1.32 +/- 0.04 L/min) outperformed the basket type (the best performing comparator) (1.02 +/- 0.08 L/min) by 23% (p < 0.005). When the preload was increased to 4 mmHg under PVD conditions, the same trend was noted with the prototype cannula (1.65 +/- 0.05 L/min), outperforming the basket cannula's value (1.26 +/- 0.05 L/min) by 24% (p < 0.001). This new cannula design provides superior flow characteristics, under all test conditions, compared to the classic single-stage venous cannulae used for paediatric CPB surgery.
在体外循环（CPB）期间，静脉引流可能会因血管和插管尺寸较小或颤动而受阻，从而导致回输给心肺机的血液减少。我们设计了一种可自扩张的原型插管，它能够保持静脉通畅并克服这一问题，并分析了其性能。使用7mm的入路血管直径对该原型插管和其他几种插管进行了测试。建立了一个体外循环回路，用一根10mm的彭罗斯乳胶管模拟患者静脉，置于患者预负荷储液器和插管之间，包裹插管的入口。在2和4mmHg的预负荷（P）下测定被动静脉引流（PVD）的最大流速。我们将这些结果与三种经典的单级静脉插管进行了比较：篮状尖端插管、胸腔引流管和经皮尖端插管。在PVD条件和2mmHg的中心静脉压（CVP）下，将其他插管与原型插管进行比较，原型插管的流速（1.32±0.04L/min）比表现最佳的比较对象篮状插管（1.02±0.08L/min）高出23%（p<0.005）。在PVD条件下，当预负荷增加到4mmHg时，原型插管也出现了相同的趋势（1.65±0.05L/min），比篮状插管的值（1.26±0.05L/min）高出24%（p<0.001）。与用于小儿CPB手术的经典单级静脉插管相比，这种新的插管设计在所有测试条件下都具有更好的血流特性。
