Acute hemodynamic efficacy of a 32-ml subcutaneous counterpulsation device in a calf model of diminished cardiac function.
Acute hemodynamic efficacy of a 32-ml subcutaneous counterpulsation device in a calf model of diminished cardiac function.
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DOI：
10.1097/mat.0b013e318186891f
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发表时间：
2008-11
期刊：
影响因子：
--
通讯作者：
Spence PA
中科院分区：
文献类型：
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作者：
Koenig SC;Litwak KN;Giridharan GA;Pantalos GM;Dowling RD;Prabhu SD;Slaughter MS;Sobieski MA;Spence PA
评价植入式反搏器(CPD)的急性血流动力学效果。CPD是一种无瓣膜单端口、32毫升每搏量的血腔，旨在通过简单的表面外科程序连接到人体腋动脉。血液在收缩时被吸入泵中，在舒张期被排出。比较32毫升CPD和标准临床40毫升主动脉内球囊反搏(IABP)对小牛(80公斤，n=10)的急性血流动力学影响。小牛口服单剂量莫能菌素，以制造心脏功能减退(DCF)的模型。与DCF(P<；0.05)相比，CPD和IABP在心输出量(6%CPD比5%IABP，p>；0.5)方面有相似的增加，而左心室外做功(14%CPD比13%IABP，p>；0.5)减少。然而，与IABP相比，CPD组的舒张期冠状动脉流量与左心室外做功增加的比率(P<；0.05)高于IABP组(15%比4%，P<；0.05)。与IABP(13%比9%，p<；0.05)相比，CPD在DCF基线(p<；0.05)的基础上降低了左心室心肌耗氧量(p<；0.05)，尽管两种装置在心输出量方面都有类似的改善。没有溶血、血栓形成或血管损伤的早期迹象。CPD提供了相当于IABP的血流动力学效果，并可能成为可能受益于长时间反搏的患者的一种治疗选择。
The acute hemodynamic efficacy of an implantable counter-pulsation device (CPD) was evaluated. The CPD is a valveless single port, 32-ml stroke volume blood chamber designed to be connected to the human axillary artery using a simple surface surgical procedure. Blood is drawn into the pump during systole and ejected during diastole. The acute hemodynamic effects of the 32-ml CPD were compared to a standard clinical 40-ml intra-aortic balloon pump (IABP) in calves (80 kg, n = 10). The calves were treated by a single oral dose of Monensin to produce a model of diminished cardiac function (DCF). The CPD and IABP produced similar increases in cardiac output (6% CPD vs. 5% IABP, p > 0.5) and reduction in left ventricular external work (14% CPD vs. 13% IABP, p > 0.5) compared to DCF (p < 0.05). However, the ratio of diastolic coronary artery flow to left ventricular external work increase from DCF baseline (p < 0.05) was greater with the CPD compared to the IABP (15% vs. 4%, p < 0.05). The CPD also produced a greater reduction in left ventricular myocardial oxygen consumption from DCF baseline (p < 0.05) compared to the IABP (13% vs. 9%, p < 0.05) despite each device providing similar improvements in cardiac output. There was no early indication of hemolysis, thrombus formation, or vascular injury. The CPD provides hemodynamic efficacy equivalent to an IABP and may become a therapeutic option for patients who may benefit from prolonged counterpulsation.