Kilic Ahmet, Nolan Timothy D C, Li Tieluo, Yankey G Kwame, Prastein Deyanira J, Cheng Guangming, Jarvik Robert K, Wu Zhongjun J, Griffith Bartley P
Department of Surgery, University of Maryland, Baltimore, MD 21201, USA.
ASAIO J. 2007 May-Jun;53(3):374-8. doi: 10.1097/MAT.0b013e318038fc1f.
The need for smaller, more efficient ventricular assist devices that can be used in a more chronic setting have led to exploration of mechanical circulatory support in the pediatric population. The pediatric Jarvik 2000 heart (child size), under development, was implanted in six juvenile sheep and studied for both acute fit and chronic performance evaluation. Daily hemodynamic measurements of cardiac output and pump output at varying pump speeds were taken. In addition, plasma free hemoglobin, lactic acid dehydrogenase, and platelet activation from blood samples were determined at baseline, after implantation, and twice a week thereafter. The measured flow through the outflow graft at increasing speeds from 10,000 rpm to 14,000 rpm with an increment of 1,000 rpm were 1.47 +/- 0.43, 1.89 +/- 0.52, 2.36 +/- 0.61, 2.80 +/- 0.73, and 3.11 +/- 0.86 (L/min). The baseline plasma free hemoglobin was 11.95 +/- 4.76 (mg/dL), with subsequent mean values being <30 mg/dL at postimplantation and weekly postimplantation measurements. Both lactic acid dehydrogenase and platelet activation showed an acute increase within the first week after implantation with subsequent return to baseline by 2 weeks after surgery. Our initial animal in vivo experience with the pediatric Jarvik 2000 heart shows that a small axial flow pump can provide partial to nearly complete circulatory support with minimal adverse effects on blood components.
对可用于更长期治疗的更小、更高效的心室辅助装置的需求，促使人们对儿科人群的机械循环支持进行探索。正在研发的儿科版Jarvik 2000心脏（儿童尺寸）被植入六只幼年绵羊体内，用于急性适配和慢性性能评估研究。每天在不同泵速下测量心输出量和泵输出量的血流动力学参数。此外，在基线、植入后以及此后每周两次，对血样中的血浆游离血红蛋白、乳酸脱氢酶和血小板活化情况进行测定。当转速从10,000转/分钟以1,000转/分钟的增量增加到14,000转/分钟时，通过流出移植物测得的流量分别为1.47±0.43、1.89±0.52、2.36±0.61、2.80±0.73和3.11±0.86（升/分钟）。基线血浆游离血红蛋白为11.95±4.76（毫克/分升），植入后及植入后每周测量的后续平均值均<30毫克/分升。乳酸脱氢酶和血小板活化在植入后的第一周内均出现急性升高，术后2周后恢复至基线水平。我们对儿科版Jarvik 2000心脏的初步动物体内实验表明，小型轴流泵可以提供部分至几乎完全的循环支持，且对血液成分的不良影响最小。
