Teman Nicholas R, Mazur Daniel E, Toomasian John, Jahangir Emilia, Alghanem Fares, Goudie Marcus, Rojas-Peña Alvaro, Haft Jonathan W
From the *Department of Surgery, University of Michigan, Ann Arbor, Michigan; †MC3 Inc., Ann Arbor, Michigan; and ‡Department of Cardiac Surgery, University of Michigan, Ann Arbor, Michigan.
ASAIO J. 2014 May-Jun;60(3):322-8. doi: 10.1097/MAT.0000000000000058.
It has been suggested that pulsatile blood flow is superior to continuous flow (CF) in cardiopulmonary bypass (CPB). However, adoption of pulsatile flow (PF) technology has been limited because of practicality and complexity of creating a consistent physiologic pulse. A pediatric pulsatile rotary ventricular pump (PRVP) was designed to address this problem. We evaluated the PRVP in an animal model and determined its ability to generate PF during CPB. The PRVP (modified peristaltic pump, with tapering of the outlet of the pump chamber) was tested in four piglets (10-12 kg). Cannulation was performed with right atrial and aortic cannulae, and pressure sensors were inserted into the femoral arteries. Pressure curves were obtained at different levels of flow and compared with both the animal's baseline physiologic function and a CF roller pump. Pressure and flow waveforms demonstrated significant pulsatility in the PRVP setup compared with CF at all tested conditions. Measurement of hemodynamic energy data, including the percentage pulsatile energy and the surplus hydraulic energy, also revealed a significant increase in pulsatility with the PRVP (p < 0.001). The PRVP creates physiologically significant PF, similar to the pulsatility of a native heart, and has the potential to be easily implemented in pediatric CPB.
有人提出，在体外循环（CPB）中，脉动血流优于连续血流（CF）。然而，由于产生一致生理脉冲的实用性和复杂性，脉动流（PF）技术的应用受到限制。设计了一种儿科脉动旋转心室泵（PRVP）来解决这个问题。我们在动物模型中评估了PRVP，并确定了其在CPB期间产生PF的能力。在四只仔猪（10 - 12千克）中测试了PRVP（改良蠕动泵，泵腔出口逐渐变细）。使用右心房和主动脉插管进行插管，并将压力传感器插入股动脉。在不同流量水平下获得压力曲线，并与动物的基线生理功能和CF滚压泵进行比较。与CF相比，在所有测试条件下，PRVP设置中的压力和流量波形显示出明显的脉动性。对包括脉动能量百分比和剩余液压能在内的血流动力学能量数据的测量也显示，PRVP的脉动性显著增加（p < 0.001）。PRVP产生具有生理意义的PF，类似于天然心脏的脉动性，并且有可能在儿科CPB中轻松实施。
