使用 veno-venous 体外膜肺氧合构型评估健康动物中新型磁悬浮离心新生儿泵。

Evaluation of a new magnetically suspended centrifugal neonatal pump in healthy animals using a veno-venous extracorporeal membrane oxygenation configuration.

机构信息

Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.

Department of Intensive Care, Erasme Hospital, Brussels, Belgium.

出版信息

Perfusion. 2024 Oct;39(7):1462-1470. doi: 10.1177/02676591231202380. Epub 2023 Sep 12.

DOI:10.1177/02676591231202380

PMID:37698935

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11445975/

Abstract

BACKGROUND

The objective of this animal study was to evaluate the hemodynamic performance of a new centrifugal pump for extra-corporeal membrane oxygenation (ECMO) support in neonates.

METHODS

Six healthy swines were supported with veno-venous ECMO with the New Born ECMOLife centrifugal pump (Eurosets, Medolla, Italy) at different flow rates: 0.25, 0.5, 0.6, and 0.8 L/min; three animals were evaluated at low-flows (0.25 and 0.5 L/min) and three at high-flows (0.6 and 0.8 L/min). Each flow was maintained for 4 hours. Blood samples were collected at different time-points. Hematological and biochemical parameters and ECMO parameters [flow, revolutions per minute (RPM), drainage pressure, and the oxygenator pressure drop] were evaluated.

RESULTS

The increase of the pump flow from 0.25 to 0.5 L/min or from 0.6 to 0.8 L/min required significantly higher RPM and produced significantly higher pump pressures [from 0.25 to 0.5 L/min: 1470 (1253-1569) versus 2652 (2589-2750) RPM and 40 (26-57) versus 125 (113-139) mmHg, respectively; < .0001 for both - from 0.60 to 0.8 L/min: 1950 (1901-2271) versus 2428 (2400-2518) RPM and 66 (62-86) versus 106 (101-113) mmHg, respectively; < .0001 for both]. Median drainage pressure significantly decreased from -18 (-22; -16) mmHg to -55 (-63; -48) mmHg when the pump flow was increased from 0.25 to 0.5 L/min ( < .0001). When pump flow increased from 0.6 to 0.8 L/min, drainage pressure decreased from -32 (-39; -24) mmHg to -50 (-52; -43) mmHg, ( < .0001). Compared to pre-ECMO values, the median levels of lactate dehydrogenase, d-dimer, hematocrit, and platelet count decreased after ECMO start at all flow rates, probably due to hemodilution. Plasma-free hemoglobin, instead, showed a modest increase compared to pre-ECMO values during all experiments at different pump flow rates. However, these changes were not clinically relevant.

CONCLUSIONS

In this animal study, the "New Born ECMOLife" centrifugal pump showed good hemodynamic performance. Long-term studies are needed to evaluate biocompatibility of this new ECMO pump.

摘要

背景

本动物研究的目的是评估一种新型离心式体外膜肺氧合（ECMO）泵在新生儿中的血液动力学性能。

方法

6 只健康猪在不同流量下接受静脉-静脉 ECMO 支持：0.25、0.5、0.6 和 0.8 L/min；3 只动物在低流量（0.25 和 0.5 L/min）下进行评估，3 只在高流量（0.6 和 0.8 L/min）下进行评估。每种流量均维持 4 小时。在不同时间点采集血样。评估血液学和生化参数以及 ECMO 参数[流量、每分钟转数（RPM）、引流压力和氧合器压降]。

结果

从 0.25 增加到 0.5 L/min 或从 0.6 增加到 0.8 L/min 时，泵流量的增加需要更高的 RPM，并产生更高的泵压[从 0.25 增加到 0.5 L/min：1470（1253-1569）对 2652（2589-2750）RPM 和 40（26-57）对 125（113-139）mmHg，均为 <.0001；从 0.60 增加到 0.8 L/min：1950（1901-2271）对 2428（2400-2518）RPM 和 66（62-86）对 106（101-113）mmHg，均为 <.0001]。当泵流量从 0.25 增加到 0.5 L/min 时，中位引流压力从-18（-22；-16）mmHg 显著降低至-55（-63；-48）mmHg（ <.0001）。当泵流量从 0.6 增加到 0.8 L/min 时，引流压力从-32（-39；-24）mmHg 降低至-50（-52；-43）mmHg（ <.0001）。与 ECMO 前相比，在所有流量下，乳酸脱氢酶、D-二聚体、红细胞压积和血小板计数的中位数水平在 ECMO 开始后均降低，可能是由于血液稀释。然而，与 ECMO 前相比，在不同的泵流量下，血浆游离血红蛋白在所有实验中均显示出适度增加。然而，这些变化没有临床意义。