Rotary Blood Pump Control Strategy for Preventing Left Ventricular Suction

Rotary Blood Pump Control Strategy for Preventing Left Ventricular Suction
复制标题

防止左心室抽吸的旋转血泵控制策略

DOI：
--
复制
发表时间：
2015
期刊：
ASAIO journal (1992)
影响因子：
--
通讯作者：
G. Giridharan
G. Giridharan
中科院分区：
--
文献类型：
--
作者：
Yu Wang;S. Koenig;M. Slaughter;G. Giridharan

文献摘要

被引文献

相似文献

在连续流LV辅助装置（LVAD）支持期间，在一系列生理条件下保持充分灌注的同时进行左心室（LV）抽吸的风险是一个重要的临床问题。为了应对这一挑战，我们开发了一种用于轴向和离心LVAD的抽吸预防和生理控制（SPPC）算法。SPPC算法使用两个增益调度比例积分控制器，可将泵速差（RPM）维持在用户定义的阈值以上，以防止LV抽吸，同时维持LV和主动脉之间的平均参考压差（P），以提供生理灌注。在模拟休息和运动测试条件下，通过计算机模拟评价了所提出算法的有效性和稳健性，包括（1）P/RPM过度设定点（ES）;（2）肺血管阻力（PVR）快速增加8倍;以及（3）ES和PVR。模拟并分析血液动力学波形（LV压力和容量;主动脉压力和流量），以识别抽吸事件，量化总流量输出（泵+心输出量），并表征SPPC算法的性能。结果表明，在所有模拟测试条件下，所提出的SPPC算法在保持生理灌注的同时防止LV抽吸，并保证在体内进行进一步研究。
The risk for left ventricular (LV) suction while maintaining adequate perfusion over a range of physiologic conditions during continuous flow LV assist device (LVAD) support is a significant clinical concern. To address this challenge, we developed a suction prevention and physiologic control (SPPC) algorithm for use with axial and centrifugal LVADs. The SPPC algorithm uses two gain-scheduled, proportional-integral controllers that maintain a differential pump speed (&Dgr;RPM) above a user-defined threshold to prevent LV suction, while maintaining an average reference differential pressure (&Dgr;P) between the LV and aorta to provide physiologic perfusion. Efficacy and robustness of the proposed algorithm were evaluated in silico during simulated rest and exercise test conditions for (1) &Dgr;P/&Dgr;RPM excessive setpoint (ES); (2) rapid eightfold increase in pulmonary vascular resistance (PVR); and (3) ES and PVR. Hemodynamic waveforms (LV pressure and volume; aortic pressure and flow) were simulated and analyzed to identify suction event(s), quantify total flow output (pump + cardiac output), and characterize the performance of the SPPC algorithm. The results demonstrated that the proposed SPPC algorithm prevented LV suction while maintaining physiologic perfusion for all simulated test conditions, and warrants further investigation in vivo.