Pulsatile Venoarterial Perfusion Using a Novel Synchronized Cardiac Assist Device Augments Coronary Artery Blood Flow During Ventricular Fibrillation
Pulsatile Venoarterial Perfusion Using a Novel Synchronized Cardiac Assist Device Augments Coronary Artery Blood Flow During Ventricular Fibrillation
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DOI：
10.1111/aor.12413
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发表时间：
2015-01-01
影响因子：
2.4
通讯作者：
Laufs, Ulrich
中科院分区：
文献类型：
--
作者：
Cremers, Bodo;Link, Andreas;Laufs, Ulrich
心源性休克患者的死亡率很高。在这里，我们报告的第一次使用的经皮脉动心脏辅助装置，根据对角泵同步的心脏周期，通过心电图信号在成年猪。8头家猪接受强制通气。在窦性心律期间，搏动性和非搏动性灌注在肺动脉压、肺楔压、中心静脉压、平均动脉压（MAP）、平均脉压和平均冠状动脉流量（CAF）方面没有差异。心脏完全停搏2分钟后（室颤），在静脉动脉非搏动体外膜氧合（ECMO）模式（3L/min）下使用i-cor的循环支持恢复了体循环，MAP增加至78.3mmHg，CAF增加至5.27mL/min。（3L/min，75 bpm，脉幅范围3500 rpm），MAP无明显变化（75.6mmHg）; CAF增至8.45mL/min，转为非搏动模式后MAP保持稳定（83.6mmHg），但CAF降至4.85mL/min。此后，建立搏动性心脏辅助，血流量降至2.5L/min，脉冲幅度范围扩大至4500 rpm。在此条件下，MAP保持稳定（71.0mmHg），但CAF显著增加至15.2mL/min（P
Patients with cardiogenic shock have a very high mortality. Here we report the first use of a percutaneous pulsatile cardiac assist device, based on a diagonal pump synchronized with the heart cycle by means of an electrocardiographic signal in adult pigs. Eight domestic pigs underwent mandatory ventilation. During sinus rhythm, there were no differences between pulsatile and nonpulsatile perfusion with regard to pulmonary artery pressure, pulmonary wedge pressure, central venous pressure, mean arterial pressure (MAP), mean pulse pressure, and mean coronary artery flow (CAF). After 2min of complete cardiac arrest (ventricular fibrillation), circulatory support with the i-cor in venoarterial nonpulsatile extracorporeal membrane oxygenation (ECMO) mode (3L/min) restored systemic circulation, with an increase of MAP to 78.3mmHg and CAF to 5.27mL/min. After changing from ECMO settings to pulsatile mode (3L/min, 75bpm, pulse amplitude range 3500rpm), MAP did not change significantly (75.6mmHg); however, CAF increased to 8.45mL/min. After changing back to nonpulsatile mode, MAP remained stable (83.6mmHg), but CAF decreased to 4.85mL/min. Thereafter, pulsatile cardiac assist was established with a reduced blood flow of 2.5L/min, and the pulse amplitude range was extended to 4500 rpm. Under these conditions, MAP remained stable (71.0mmHg), but CAF significantly increased to 15.2mL/min (P