Rho Y R, Choi H, Lee J C, Choi S W, Chung Y M, Lee H S, Hwang C M, Lee H S, Ahn S S, Lee R Y, Son H S, Choi M J, Baek K J, Kim J S, Suh G J, Won Y S, Sun K, Min B G
Interdisciplinary Program in Biomedical Engineering Major, Graduate School, Seoul National University, Seoul, Korea.
Int J Artif Organs. 2003 May;26(5):428-35. doi: 10.1177/039139880302600509.
T-PLS (Twin-Pulse Life Support) is the first commercial pulsatile ECLS (Extra Corporeal Life Support) device (1). The dual sac structure of T-PLS can effectively reduce high membrane oxygenator inlet pressure and hemolysis. To verify both the use of T-PLS for ECLS and the advantages of T-PLS, we tested various models.
In the partial CPB (cardio pulmonary bypass) model (swine), T-PLS (N = 6), and Biopump (N = 2), a single pulsatile pump (N = 2), were compared. In the case of single pulsatile flow, during pump systole, pressure increased to 700 - 800 mmHg at the inlet port of the membrane oxygenator. fHb, a hemolysis measurement value, was about 80 mg/dL at 3 hours. On the contrary, because of T-PLS's dual sac system, the pressure of T-PLS had a maximum value of about 250 mmHg and fHb was similar to that of the commercial centrifugal pumps. In the total CPB model (bovine, N = 6), the heart was stopped via cardioplegia (Kcl). T-PLS flow was maintained at 3.0-4.5 L/min. T-PLS functioned like a natural heart, having a pulse pressure of 26-43 mmHg and a pulse rate of 40-60 bpm (beats per minute). In the emergency case model (canine, N = 6), T-PLS was started 10 minutes after cardiac arrest from electronic shock. In spite of cardiac arrest for a period of 40 minutes, the heart was recovered after defibrillation. In the ARDS (Acute Respiratory Distress Syndrome) model (canine, N = 6), minimal ventilator parameters were set: tidal volume 130 ml, respiration rate = bpm, FiO2 = 10%. Three hours after starting T-PLS, PO2 of the carotid artery blood (after 2 hours: 195 +/- 89.4; after 3 hours: 258 +/- 99.3 mmHg) was above half the value of the femoral artery but was within normal range.
It is suggested that a portable pulsatile ECLS like T-PLS may be used as a CPB device and as an alternative CPR (cardiopulmonary resuscitation) device in the case of cardiac arrest. Due to the pulsatile flow, oxygenated blood is delivered to the patient without overloading the ARDS patients heart.
T-PLS（双脉冲生命支持系统）是首个商业化的搏动性体外生命支持（ECLS）设备（1）。T-PLS的双囊结构可有效降低膜式氧合器入口的高压和溶血现象。为验证T-PLS用于ECLS的可行性及其优势，我们测试了多种型号。
在部分体外循环（CPB）模型（猪）中，对T-PLS（N = 6）、Biopump（N = 2）和一种单搏动泵（N = 2）进行了比较。在单搏动血流情况下，泵收缩期时，膜式氧合器入口处压力升至700 - 800 mmHg。溶血测量值fHb在3小时时约为80 mg/dL。相反，由于T-PLS的双囊系统，T-PLS的压力最大值约为250 mmHg，且fHb与商用离心泵的相似。在全CPB模型（牛，N = 6）中，通过心脏停搏液（氯化钾）使心脏停跳。T-PLS的血流维持在3.0 - 4.5 L/分钟。T-PLS的功能类似自然心脏，脉压为26 - 43 mmHg，心率为40 - 60次/分钟（每分钟心跳次数）。在紧急情况模型（犬，N = 6）中，心脏因电击骤停10分钟后启动T-PLS。尽管心脏骤停40分钟，但除颤后心脏恢复。在急性呼吸窘迫综合征（ARDS）模型（犬，N = 6）中，设置最低呼吸机参数：潮气量130 ml，呼吸频率 = 心跳次数，吸入氧浓度 = 10%。启动T-PLS 3小时后，颈动脉血的氧分压（2小时后：195 +/- 89.4；3小时后：258 +/- 99.3 mmHg）高于股动脉血氧分压值的一半，但仍在正常范围内。
提示像T-PLS这样的便携式搏动性ECLS可作为CPB设备，以及在心脏骤停时作为心肺复苏（CPR）的替代设备使用。由于搏动血流，可在不加重ARDS患者心脏负担的情况下将氧合血输送给患者。
