Department of Pediatrics, Department of Surgery and Bioengineering, Penn State Hershey Pediatric Cardiovascular Research Center, Penn State Hershey Children's Hospital, Hershey, PA 17033-0850, USA.
Artif Organs. 2013 Jan;37(1):48-56. doi: 10.1111/aor.12026.
A simple, inexpensive pediatric pulsatile roller blood pump has been utilized for routine cardiopulmonary bypass (CPB) procedures, extracorporeal life support (ECLS), and left/right ventricular assist systems (LVAS/RVAS) for decades in France. This particular nonocclusive pulsatile system has many advantages including several safety features for patients as well as an extremely lower cost. The objective of this study is to evaluate the performance of this particular system for CPB, ECLS, and LVAS/RVAS in pulsatile mode. This pediatric nonocclusive system was evaluated with pump flow rates of 500, 750, and 1000 mL/min under normothermic (35°C) and hypothermic (25°C) conditions in CPB, ECLS, and LVAS/RVAS circuits using clinical disposables and settings. Energy equivalent pressure (EEP), surplus homodynamic energy (SHE), and total hemodynamic energy (THE) were calculated for each experimental stage. The pump generated near physiological quality of pulsatile flow without backflow in the three simulated pediatric circuits. With increased flow rates, more hemodynamic energy was delivered to the pseudo patient. This particular nonocclusive pediatric pulsatile system performed well during all of the experimental conditions and generated adequate quality pulsatile pressure-flow waveforms using CPB, ECLS, and LVAS/RVAS circuitry. Although this novel concept was first introduced in the 1990s, we believe that there is still need for this technology (with engineering modifications) because of significant advantages including safety and cost.
几十年来,法国一直在将一种简单、廉价的儿科搏动式滚压血泵用于常规体外循环(CPB)、体外生命支持(ECLS)和左/右心室辅助系统(LVAS/RVAS)。这种特殊的非阻塞性搏动系统具有许多优点,包括为患者提供多项安全功能,以及极其低廉的成本。本研究的目的是评估该特殊系统在 CPB、ECLS 和 LVAS/RVAS 搏动模式下的性能。该儿科非阻塞系统在 CPB、ECLS 和 LVAS/RVAS 回路中,在常温(35°C)和低温(25°C)条件下,以 500、750 和 1000 mL/min 的泵流量进行了评估,使用临床即用型耗材和设置。为每个实验阶段计算了等效压力(EEP)、剩余血液动力学能量(SHE)和总血液动力学能量(THE)。该泵在三个模拟儿科回路中产生了接近生理质量的搏动性流动,没有回流。随着流速的增加,更多的血液动力学能量被输送到假性患者。在所有实验条件下,这种特殊的非阻塞儿科搏动系统都表现良好,并使用 CPB、ECLS 和 LVAS/RVAS 电路生成了足够质量的搏动压力-流量波形。尽管这种新概念在 20 世纪 90 年代首次推出,但我们认为,由于其具有安全性和成本等显著优势,仍需要对这项技术(进行工程改进)。