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低流量体外生命支持中的血液加温、泵体加热与溶血:一项使用新鲜捐献人血的体外研究

Blood warming, pump heating and haemolysis in low-flow extracorporeal life support; an in vitro study using freshly donated human blood.

作者信息

Kusters R W J, Simons A P, Lancé M D, Ganushchak Y M, Bekers O, Weerwind P W

机构信息

1 Department of Cardiothoracic Surgery, Maastricht University Medical Centre and Cardiovascular Research Institute Maastricht, Maastricht, the Netherlands.

2 Department of Anesthesiology and Pain Treatment, Maastricht University Medical Centre, Maastricht, the Netherlands.

出版信息

Perfusion. 2017 Jan;32(1):27-34. doi: 10.1177/0267659116656045. Epub 2016 Jul 19.

Abstract

Low-flow extracorporeal life support can be used for cardiopulmonary support of paediatric and neonatal patients and is also emerging as a therapy for patients suffering from exacerbation of chronic obstructive pulmonary disease. However, pump heating and haemolysis have proven to negatively affect the system and outcome. This in vitro study aimed at gaining insight into blood warming, pump heating and haemolysis related to the performance of a new low-flow centrifugal pump. Pump performance in the 400-1,500 ml/min flow range was modulated using small-sized dual-lumen catheters and freshly donated human blood. Measurements included plasma free haemoglobin, blood temperature, pump speed, pump pressure, blood flow and thermographic imaging. Blood warming (ΔT=0.5°C) had no relationship with pump performance or haemolysis (R=0.05). Pump performance-related parameters revealed no relevant relationships with haemolysis (R=0.36). Thermography showed no relevant heat zones in the pump (T=36°C). Concerning blood warming, pump heating and haemolysis, we deem the centrifugal pump applicable for low-flow extracorporeal circulation.

摘要

低流量体外生命支持可用于儿科和新生儿患者的心肺支持,并且也正成为治疗慢性阻塞性肺疾病急性加重患者的一种疗法。然而,已证实泵发热和溶血会对该系统及治疗结果产生负面影响。这项体外研究旨在深入了解与新型低流量离心泵性能相关的血液升温、泵发热和溶血情况。在400至1500毫升/分钟的流量范围内,使用小型双腔导管和新鲜捐赠的人体血液来调节泵的性能。测量指标包括血浆游离血红蛋白、血液温度、泵速、泵压、血流量和热成像。血液升温(ΔT = 0.5°C)与泵性能或溶血无关(R = 0.05)。与泵性能相关的参数显示与溶血无显著关系(R = 0.36)。热成像显示泵内无相关热区(T = 36°C)。关于血液升温、泵发热和溶血,我们认为该离心泵适用于低流量体外循环。

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