Jung Jae Seung, Son Ho Sung, Lim Choon Hak, Sun Kyung
Thoracic and Cardiovascular Surgery, Korea Artificial Organ Center, Korea University, Seoul, Korea.
ASAIO J. 2007 Nov-Dec;53(6):785-90. doi: 10.1097/MAT.0b013e31815b2d00.
How much flow is required by a nonpulsatile pump to match the coronary blood flow equivalent to that of pulsatile pump? A cardiopulmonary bypass circuit from the right atrium to the ascending aorta was constructed in a ventricular fibrillation model using 13 Yorkshire swine. The animals were randomly divided into two groups: CONTROL (pulsatile T-PLS, n = 7) or EXPERIMENTAL (nonpulsatile Biopump, n = 6). The hemodynamic data at mid-LAD level was measured with a flow meter at baseline and every 20 minutes after pump flow initiation. The pump flow was started from 2 L/min in both groups (67 +/- 8 in CONTROL and 70 +/- 9 ml/kg/min in EXPERIMENTAL; p = NS), and the pump flow of the EXPERIMENTAL group was increased to match the coronary flow of the CONTROL group. To maintain mean velocity and flow in the LAD, the EXPERIMENTAL group required significantly higher pump flow at 20, 40, and 60 minutes (84 +/- 17 vs. 67 +/- 8, 87 +/- 24 vs. 67 +/- 8, 85 +/- 18 vs. 67 +/- 8 ml/kg/min, respectively, p < 0.05). The LAD diameter was substantially smaller in the CONTROL group and the resistance index was significantly lower in the CONTROL group at 80 minutes and 120 minutes after bypass (0.56 +/- 0.26 vs. 0.87 +/- 0.20 and 0.61 +/- 0.23 vs. 0.90 +/- 0.06; p < 0.05). In conclusion, we found that the nonpulsatile pump may require 25%-28% higher pump flow than the pulsatile pump to maintain equivalent coronary blood flow.
非搏动性泵需要多少流量才能与搏动性泵的冠状动脉血流量相当？在13只约克夏猪的心室颤动模型中构建了一个从右心房到升主动脉的体外循环回路。动物被随机分为两组：对照组（搏动性T-PLS，n = 7）或实验组（非搏动性Biopump，n = 6）。在基线时以及启动泵流后每20分钟，用流量计测量左前降支（LAD）中段水平的血流动力学数据。两组均从2 L/min开始泵流（对照组为67±8，实验组为70±9 ml/kg/min；p =无显著性差异），实验组的泵流增加以匹配对照组的冠状动脉血流量。为了维持LAD中的平均速度和流量，实验组在20、40和60分钟时需要显著更高的泵流（分别为84±17 vs. 67±8、87±24 vs. 67±8、85±18 vs. 67±8 ml/kg/min，p < 0.05）。在体外循环后80分钟和
