Cardiovascular Surgery Department, Clínica Universitaria, University of Navarra, Pamplona, Spain.
Artif Organs. 2010 Feb;34(2):140-6. doi: 10.1111/j.1525-1594.2009.00769.x. Epub 2010 Jan 18.
The aim of this study was to assess platelet dysfunction and damage to organs after extracorporeal circulation using a pump based on a new method that adds a pulsatile flow to the continuous flow provided by a centrifugal pump. The continuous component of the total flow (2-3 L/min) is created by a Bio-Pump centrifugal pump, while the pulsatile component is created by the pulsating of an inner membrane pneumatically controlled by an intra-aortic counterpulsation balloon console (systolic volume of 37.5 mL in an asynchronous way with a frequency of 60 bpm). Six pigs were subjected to a partial cardiopulmonary bypass lasting 180 min and were sacrificed 60 min after extracorporeal circulation was suspended. The hematological study included the measurement of hematocrit, hemoglobin, leukocytes, and platelet function. The new pump did not significantly alter either platelet count or platelet function. In contrast, hematocrit and hemoglobin were significantly reduced during extracorporeal circulation (approximately 5% P = 0.011, and 2 g/dL P = 0.01, respectively). The leukocyte count during extracorporeal circulation showed a tendency to decrease, but this was not significant. In general, the short-term use of the new pump (4 h) did not cause any serious morphological damage to the heart, lung, kidney, or liver. The results suggest that the hemodynamic performance of the new pump is similar to a conventional centrifugal pump and could therefore be appropriate for use in extracorporeal circulation.
本研究旨在评估体外循环后血小板功能障碍和器官损伤,采用一种基于新方法的泵,该方法在离心泵提供的连续流中添加脉动流。总流量的连续部分(2-3 L/min)由 Bio-Pump 离心泵产生,而脉动部分由气动控制的内膜产生,由主动脉内反搏球囊控制台控制(异步方式下的收缩容积为 37.5 mL,频率为 60 bpm)。六头猪进行了 180 分钟的部分心肺旁路,在体外循环停止后 60 分钟处死。血液学研究包括测量血细胞比容、血红蛋白、白细胞和血小板功能。新型泵对血小板计数或血小板功能没有显著影响。相比之下,血细胞比容和血红蛋白在体外循环期间显著降低(分别约为 5%,P=0.011 和 2 g/dL,P=0.01)。体外循环期间白细胞计数呈下降趋势,但无统计学意义。总的来说,新型泵的短期使用(4 小时)未导致心脏、肺、肾或肝发生任何严重的形态学损伤。结果表明,新型泵的血液动力学性能与传统离心泵相似,因此可适用于体外循环。