Reiss N, Morshuis M, Landich R, Frerichs I, Frerichs A, Hellige G, Illian M, Dramburg W, Scheid P, Minami K, Körfer R
Clinic for Thoracic and Cardiovascular Surgery, Heart Center North Rhine-Westphalia, Ruhr University of Bochum, Bad Oeynhausen, Germany.
Int J Artif Organs. 1998 Jul;21(7):417-24.
The main limitation in the use of circulatory support in children is the lack of an adequate system with regard to size and pumping capacity. Recently, two pneumatically driven ventricular support systems with low volume chambers for use in a pediatric population became available. We have developed a hydraulic drive system with an advantageous exact control of the stroke volume. The system enables two different modes of operation: the full-empty and the filled-empty modes. In both cases the ventricle is empty at the end of systole. This new system was tested in experimental animals (6 pigs, body weight 9.5-14.0 kg) with normal and reduced left ventricular function (MAP<45 mmHg). A 25 ml ventricle (HIA-Medos) was implanted. The full-empty and the filled-empty mode used led to a significant load reduction, both in animals with normal and impaired cardiac function. Plasma lactate levels, pH-values and total body O2-consumption were in the normal range during circulatory support indicating adequate organ perfusion. Results showed that sufficient ventricular support was achieved during all pumping modes due to the possibility of controlling and modifying the stroke volume of the hydraulically driven support system employed according to necessity. This is a promising feature for its future application in infants with congenital or acquired heart diseases.
儿童循环支持使用中的主要限制在于缺乏尺寸和泵血能力合适的系统。最近，两种用于儿科人群的、带有小容积腔室的气动心室支持系统问世。我们开发了一种液压驱动系统，其对每搏量能进行精确控制，具有优势。该系统有两种不同的运行模式：全排空模式和充盈-排空模式。在这两种情况下，心室在收缩期末均为空。此新系统在左心室功能正常和降低（平均动脉压<45 mmHg）的实验动物（6头猪，体重9.5 - 14.0 kg）身上进行了测试。植入了一个25毫升的心室（HIA - Medos）。无论是心功能正常还是受损的动物，采用的全排空模式和充盈-排空模式均导致负荷显著降低。循环支持期间血浆乳酸水平、pH值和全身氧耗均在正常范围内，表明器官灌注充足。结果显示，由于能够根据需要控制和调整所采用的液压驱动支持系统的每搏量，在所有泵血模式下均实现了足够的心室支持。这对于其未来应用于先天性或后天性心脏病患儿而言是一个有前景的特性。
