Hering J P, Schröder T, Uhlig P, Scholz K H, Tebbe U, Kreuzer H, Hellige G
Department of Experimental Cardiology, University of Göttingen, Germany.
Thorac Cardiovasc Surg. 1991 Oct;39(5):257-62. doi: 10.1055/s-2007-1019982.
A study was designed to quantify the influence of the Hemopump on myocardial metabolism in regional myocardial ischemias induced by repetitive balloon-occlusions (3.5 minutes) of the LAD in 12 sheep (b.w. 49-61 kg). In order to make immediate comparisons and obtain paired-couples, ischemias were carried out with and without the Hemopump in operation. An energetic unloading of the left ventricle was achieved by the Hemopump already under preocclusion conditions, reducing myocardial O2-consumption from 7.52 to 5.98 ml/min/100 g LV (= 20%) as well as lowering the LVEDP from 13.3 to 9.8 mmHg (p less than or equal to 0.01). During ischemia a clear increase of LVEDP (13.3 to 21.0 mmHg) occurs, which was prevented in the group with Hemopump-assist (9.8 to 12.1 mmHg). Combined with a sustained higher diastolic aortic pressure, a better myocardial perfusion pressure resulted. Energetic unloading and improvement of perfusion conditions might be the cause of the significantly lowered release of lactate and potassium. Due to theses fibrillation (n = 3) only occurred during occlusions without Hemopump-support. In summary, a significant reduction of the ischemic burden on the myocardium was found. Thus the Hemopump could be of benefit to patients who fail to be weaned from CPB or who are suffering from instable cardiovascular performance.
一项研究旨在量化Hemopump对12只绵羊（体重49 - 61千克）左前降支重复球囊闭塞（3.5分钟）诱导的局部心肌缺血中心肌代谢的影响。为了立即进行比较并获得配对组，在有和没有Hemopump运行的情况下进行缺血实验。在预闭塞条件下，Hemopump已经实现了左心室的能量卸载，将心肌耗氧量从7.52降至5.98毫升/分钟/100克左心室（= 20%），并将左心室舒张末压从13.3降至9.8毫米汞柱（p≤0.01）。在缺血期间，左心室舒张末压明显升高（从13.3升至21.0毫米汞柱），而在Hemopump辅助组中这种升高得到了预防（从9.8升至12.1毫米汞柱）。与持续较高的舒张期主动脉压相结合，产生了更好的心肌灌注压。能量卸载和灌注条件的改善可能是乳酸和钾释放显著降低的原因。由于这些原因，仅在没有Hemopump支持的闭塞期间发生了3次纤颤。总之，发现心肌的缺血负担显著减轻。因此，Hemopump可能对无法脱离体外循环或患有心血管功能不稳定的患者有益。
