Physiological control of dual rotary pumps as a biventricular assist device using a master/slave approach.
Physiological control of dual rotary pumps as a biventricular assist device using a master/slave approach.
复制标题
使用主/从方法对双旋转泵作为双心室辅助装置进行生理控制。
DOI：
10.1111/aor.12303
复制
发表时间：
2014
影响因子：
2.4
通讯作者：
D. Timms
中科院分区：
文献类型：
--
作者：
M. Stevens;Stephen J Wilson;A. Bradley;J. Fraser;D. Timms
双旋转左心室辅助装置（lvad）可以在心力衰竭时提供双心室机械支持。左泵和右泵速度的协调不仅对避免心室吸引和使心输出量与需求相匹配至关重要，而且对确保全身和肺循环容量的平衡也至关重要。双lvad的生理控制系统必须通过自动调节左右泵速来满足各种临床情况下的这些目标，以避免灾难性的生理后果。在本研究中，我们评估了一种新型的双lvad主从生理控制系统。主控制器是一个类似斯特林的控制器，它将流速设定为舒张末期心室压（EDP）的函数。然后，从控制器在左右edp之间保持线性关系。通过在模拟循环循环中模拟四种临床情景（休息、姿势变化、Valsalva演习和锻炼）来评估左/右和右/左主/从组合。将该控制器的性能与恒转速控制和另外两种双LVAD控制系统（双恒定进口压力和双Frank-Starling控制）进行了比较。结果表明，主从生理控制系统产生的吸力事件比等速控制系统少（7分钟内6次vs 62次）。与其他控制系统相比，左/右主/从控制系统的肺充血风险较低，最大edp较低（15.1 vs 25.2-28.4 mm Hg）。在运动期间，主/从控制将总流量从5.2升/分钟增加到10.1升/分钟，主要是由于左右泵转速的增加。使用左泵作为主泵，与使用右泵相比，抽吸事件更少，edp更低。基于这些结果，使用左泵作为主泵的主/从控制自动调整泵速，以避免吸入，并在运动期间增加泵流量，而不会引起肺静脉充血。
Dual rotary left ventricular assist devices (LVADs) can provide biventricular mechanical support during heart failure. Coordination of left and right pump speeds is critical not only to avoid ventricular suction and to match cardiac output with demand, but also to ensure balanced systemic and pulmonary circulatory volumes. Physiological control systems for dual LVADs must meet these objectives across a variety of clinical scenarios by automatically adjusting left and right pump speeds to avoid catastrophic physiological consequences. In this study we evaluate a novel master/slave physiological control system for dual LVADs. The master controller is a Starling-like controller, which sets flow rate as a function of end-diastolic ventricular pressure (EDP). The slave controller then maintains a linear relationship between right and left EDPs. Both left/right and right/left master/slave combinations were evaluated by subjecting them to four clinical scenarios (rest, postural change, Valsalva maneuver, and exercise) simulated in a mock circulation loop. The controller's performance was compared to constant-rotational-speed control and two other dual LVAD control systems: dual constant inlet pressure and dual Frank-Starling control. The results showed that the master/slave physiological control system produced fewer suction events than constant-speed control (6 vs. 62 over a 7-min period). Left/right master/slave control had lower risk of pulmonary congestion than the other control systems, as indicated by lower maximum EDPs (15.1 vs. 25.2-28.4 mm Hg). During exercise, master/slave control increased total flow from 5.2 to 10.1 L/min, primarily due to an increase of left and right pump speed. Use of the left pump as the master resulted in fewer suction events and lower EDPs than when the right pump was master. Based on these results, master/slave control using the left pump as the master automatically adjusts pump speed to avoid suction and increases pump flow during exercise without causing pulmonary venous congestion.
在 DexAide 右心室辅助装置中引入固定流量模式。
DOI：
10.1016/j.healun.2009.09.004
发表时间：
2010
期刊：
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
影响因子：
--
作者：
Saeed,Diyar;Massiello,AlexL;Shalli,Shanaz;Fumoto,Hideyuki;Horai,Tetsuya;Anzai,Tomohiro;Golding,LeonardAR;Fukamachi,Kiyotaka
通讯作者：
Fukamachi,Kiyotaka