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基于搏动率的左心室辅助装置血流动力学控制器

Hemodynamic controller for left ventricular assist device based on pulsatility ratio.

作者信息

Choi Seongjin, Boston J Robert, Antaki James F

机构信息

Department of Electronics and Information Engineering, Korea University, Jochiwon, Chungnam, Korea.

出版信息

Artif Organs. 2007 Feb;31(2):114-25. doi: 10.1111/j.1525-1594.2007.00350.x.

Abstract

Hemodynamic control of left ventricular assist devices (LVADs) is generally a complicated problem due to diverse operating environments and the variability of the patients: both the changes in the circulatory and metabolic parameters as well as disturbances that require adjustment to the operating point. This challenge is especially acute with control of turbodynamic blood pumps. This article presents a pulsatility ratio controller for LVAD that provides a proper perfusion according to the physiological demands of the patient, while avoiding adverse conditions. It utilizes the pulsatility ratio of the flow through the pump and pressure difference across the pump as a control index and adjusts the pump speed according to the reference pulsatility ratio under the different operating conditions. The simulation studies were performed to evaluate the controller in consideration of the sensitivity to afterload and preload, influence of the contractility, and effect of suction sensitivity. The controller successfully adjusts the pump speed according to the reference pulsatility ratio, and supports the natural heart under diverse pump operating conditions. The resulting safe pump operations demonstrate the solid performance of the controller in terms of sensitivity to afterload and preload, influence of the contractility, and effect of suction sensitivity.

摘要

由于操作环境多样以及患者个体差异,左心室辅助装置(LVAD)的血流动力学控制通常是一个复杂的问题:循环和代谢参数会发生变化,同时还存在需要对工作点进行调整的干扰因素。对于涡轮动力血泵的控制,这一挑战尤为严峻。本文提出了一种用于LVAD的脉动率控制器,该控制器可根据患者的生理需求提供适当的灌注,同时避免不良情况的发生。它将通过泵的血流脉动率和泵两端的压差作为控制指标,并根据不同工作条件下的参考脉动率来调整泵的转速。进行了模拟研究,以评估该控制器在考虑后负荷和前负荷敏感性、收缩性影响以及抽吸敏感性效应方面的性能。该控制器成功地根据参考脉动率调整了泵的转速,并在多种泵工作条件下支持自然心脏。由此实现的安全泵操作证明了该控制器在对后负荷和前负荷的敏感性、收缩性影响以及抽吸敏感性效应方面具有可靠的性能。

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