In Vivo Evaluation of a Physiologic Control System for Rotary Blood Pumps Based on the Left Ventricular Pressure-Volume Loop.
In Vivo Evaluation of a Physiologic Control System for Rotary Blood Pumps Based on the Left Ventricular Pressure-Volume Loop.
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DOI：
10.1097/mat.0000000000001619
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发表时间：
2022-06-01
期刊：
影响因子：
4.2
通讯作者：
Rosenberg, Gerson
中科院分区：
文献类型：
--
作者：
Cysyk, Joshua;Jhun, Choon-Sik;Newswanger, Ray;Pae, Walter;Izer, Jenelle;Flory, Heidi;Reibson, John;Weiss, William;Rosenberg, Gerson
关键词：
当前一代连续流动辅助装置以固定速度操作，这限制了左心室辅助装置（LVAD）患者的预负荷响应和运动能力。开发了一种反馈控制系统，用于根据心室负荷的直接测量值自动调整泵速，该测量值使用带有集成压力传感器和容积感应电导电极的定制插管尖端。控制系统的输入是每个心动周期内左心室（LV）压力与电导环路（PGA）的积分。反馈控制系统基于测量的PGA和期望的PGA之间的差来调节泵速度。在急性绵羊研究（n=5）中，使用HeartMate II LVAD对对照系统和插管头端进行了试验。通过使用血管环圈套器部分闭塞和释放下腔静脉，评价对照系统的前负荷反应。将套管头端集成到定制离心流LVAD上，并在14天牛研究中进行测试。控制系统调整泵支持以维持恒定的心室负荷：泵速在前负荷增加（减少）后增加（减少）。本研究在体内证明了基于LV负荷直接测量的自动泵控制系统的Starling样反应。
Current generation continuous flow assist devices operate at a fixed speed, which limits preload response and exercise capacity in left ventricular assist device (LVAD) patients. A feedback control system was developed to automatically adjust pump speed based on direct measurements of ventricular loading using a custom cannula tip with an integrated pressure sensor and volume-sensing conductance electrodes. The input to the control system is the integral of the left ventricular (LV) pressure versus conductance loop (PGA) over each cardiac cycle. The feedback control system adjusts pump speed based on the difference between the measured PGA and the desired PGA. The control system and cannula tip were tested in acute ovine studies (n=5) using the HeartMate II LVAD. The preload response of the control system was evaluated by partially occluding and releasing the inferior vena cava using a vessel loop snare. The cannula tip was integrated onto a custom centrifugal flow LVAD and tested in a 14-day bovine study. The control system adjusted pump support to maintain constant ventricular loading: pump speed increased (decreased) following an increase (decrease) in preload. This study demonstrated in vivo the Starling-like response of an automatic pump control system based on direct measurements of LV loading.