Adedayo Pelumi, Wang Shigang, Kunselman Allen R, Ündar Akif
Department of Pediatrics, Penn State Hershey Pediatric Cardiovascular Research Center, Penn State Milton S. Hershey Medical Center, Penn State Hershey College of Medicine, Penn State Hershey Children's Hospital, Hershey, PA, USA.
Department of Public Health and Sciences, Penn State Hershey Pediatric Cardiovascular Research Center, Penn State Milton S. Hershey Medical Center, Penn State Hershey College of Medicine, Penn State Hershey Children's Hospital, Hershey, PA, USA.
World J Pediatr Congenit Heart Surg. 2014 Jul;5(3):440-8. doi: 10.1177/2150135114526760.
The objective of this study was to evaluate the pump performance of the novel diagonal Medos Deltastream DP3 diagonal pump (MEDOS Medizintechnik AG, , Stolberg, Germany) under nonpulsatile to pulsatile mode with varying differential speed values in a simulated pediatric extracorporeal life support system.
The experimental circuit consisted of a Medos Deltastream DP3 pump head and console, a Medos Hilite 2400 LT hollow fiber membrane oxygenator (MEDOS Medizintechnik AG), a 14F Medtronic DLP arterial cannula (Medtronic Inc, Minnesota), and a 20F Terumo TenderFlow Pediatric venous return cannula (Terumo Corporation, Michigan). Trials were conducted at flow rates ranging from 500 mL/min to 2,000 mL/min (500 mL/min increments) and pulsatile differential speed values ranging from 500 rpm to 2,500 rpm (500 rpm increments) using human blood (hematocrit 35%). The postcannula pressure was maintained constantly at 60 mm Hg. Real-time pressure and flow data were recorded using a custom-made data acquisition system and Labview software.
Under all experimental conditions, pulsatile flow (P) generated significantly greater energy equivalent pressure (EEP), surplus hemodynamic energy (SHE), and total hemodynamic energy (THE) than those of nonpulsatile flow (NP). Under NP, SHE was zero. Higher differential speed values generated greater EEP, SHE, and THE values. There was little variation in the oxygenator pressure drop and the cannula pressure drop in P, compared to NP.
The novel Medos Deltastream DP3 diagonal pump is able to generate physiological quality of P, without backflow. With increased differential rpm, the pump generated greater EEP, SHE, and THE. Physiological quality of pulsatility may be associated with better microcirculation because of greater EEP, SHE, and THE.
本研究的目的是在模拟小儿体外生命支持系统中，评估新型对角式美多斯德尔塔流DP3对角泵（美多斯医疗技术股份公司，德国施托尔贝格）在非搏动模式至搏动模式下，不同差速值时的泵性能。
实验回路包括一个美多斯德尔塔流DP3泵头和控制台、一个美多斯希利特2400 LT中空纤维膜式氧合器（美多斯医疗技术股份公司）、一根14F美敦力DLP动脉插管（美敦力公司，明尼苏达州）和一根20F泰尔茂嫩流小儿静脉回流插管（泰尔茂公司，密歇根州）。使用人体血液（血细胞比容35%），以500毫升/分钟至2000毫升/分钟（以500毫升/分钟递增）的流速和500转/分钟至2500转/分钟（以500转/分钟递增）的搏动差速值进行试验。插管后压力持续维持在60毫米汞柱。使用定制的数据采集系统和Labview软件记录实时压力和流量数据。
在所有实验条件下，搏动流（P）产生的能量等效压力（EEP）、剩余血流动力学能量（SHE）和总血流动力学能量（THE）均显著高于非搏动流（NP）。在NP模式下，SHE为零。更高的差速值产生更大的EEP、SHE和THE值。与NP相比，P模式下氧合器压力降和插管压力降变化很小。
新型美多斯德尔塔流DP3对角泵能够产生具有生理质量的搏动流，且无回流。随着差速转数增加，该泵产生更大的EEP、SHE和THE。由于更大的EEP、SHE和THE，搏动的生理质量可能与更好的微循环相关。
