In Vitro Hemodynamic Evaluation of ECG-Synchronized Pulsatile Flow Using i-Cor Pump as Short-Term Cardiac Assist Device for Neonatal and Pediatric Population
In Vitro Hemodynamic Evaluation of ECG-Synchronized Pulsatile Flow Using i-Cor Pump as Short-Term Cardiac Assist Device for Neonatal and Pediatric Population
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DOI：
10.1111/aor.13136
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发表时间：
2018-08-01
影响因子：
2.4
通讯作者：
Uendar, Akif
中科院分区：
文献类型：
--
作者：
Force, Madison;Moroi, Morgan;Uendar, Akif
本研究的目的是评估 i-cor 心电图同步心脏辅助系统作为新生儿和儿科患者短期心脏辅助装置的标签外使用的血流动力学特性，并比较不同幅度的非脉动血流和脉动血流。该回路由 i-cor 对角泵和 3 英尺长的 1/4 英寸动脉和静脉管以及一个软壳储液器组成，其中装有乳酸林格氏溶液和人体红细胞（血细胞比容 42%）。使用三组不同的插管（8-Fr 动脉、10-Fr 静脉、10-Fr 动脉、12-Fr 静脉和 12-Fr 动脉、14-Fr 静脉）进行试验，在不同的假患者压力（40、60、80 和 100 mm Hg）下以及在非搏动模式和具有搏动幅度的搏动模式下增加流速36 摄氏度下的转速为 2000、2500 和 3000 rpm。每次试验均使用定制的数据采集设备记录压力和流量波形。能量当量压力（EEP）在脉动模式下高于平均压力，并且随着假患者压力和流量的增加而增加，而在非脉动模式下EEP与平均压力相同。总血流动力学能量 (THE) 水平随着压力和脉动幅度的增加而增加，并随着流速的增加而略有下降。整个回路中THE损失的百分比随着流速和脉动幅度的增加而增加，并随着假患者的压力的增加而减少。 SHE 水平也随着假病人压力和脉动幅度的增加而增加，并随着流速的增加而减少。 i-cor 对角泵可用作新生儿和儿科患者的短期心脏辅助装置，能够提供非脉动和脉动血流。与非脉动流相比，脉动流可以产生并向患者输送更多的血流动力学能量。
The objective of this study was to assess the hemodynamic properties of the i-cor ECG-synchronized cardiac assist system for off-label use as a short-term cardiac assist device for neonatal and pediatric patients and compare nonpulsatile to pulsatile flow with different amplitudes. The circuit consisted of the i-cor diagonal pump with 3 feet of 1/4 inch arterial and venous tubing and a soft-shell reservoir, primed with lactated Ringer's solution and human packed red blood cells (hematocrit 42%). Trials were conducted with three different sets of cannulas (8-Fr arterial 10-Fr venous, 10-Fr arterial 12 Fr-venous, and 12-Fr arterial 14-Fr venous) with increasing flow rates at varying pseudo-patient pressures (40, 60, 80, and 100 mm Hg) and under nonpulsatile mode and pulsatile mode with pulsatile amplitudes 2000, 2500, and 3000 rpm at 36 degrees C. Pressure and flow waveforms were recorded using a custom-made data acquisition device for each trial. Energy equivalent pressure (EEP) was higher than mean pressure under pulsatile mode, and increased with increasing pseudo-patient's pressure and flow rate while EEP was the same as the mean pressure under nonpulsatile mode. Total hemodynamic energy (THE) levels increased with pressure and pulsatile amplitude and slightly decreased with increasing flow rate. The percent THE lost throughout the circuit increased with flow rate and pulsatile amplitude and decreased with pseudo-patient's pressure. SHE levels also increased with pseudo-patient pressure and pulsatile amplitude and decreased with increasing flow rate. The i-cor diagonal pump can be used as a short term cardiac assist device for neonatal and pediatric patients and is able to provide nonpulsatile as well as pulsatile flow. Compared with nonpulsatile flow, pulsatile flow can generate and deliver more hemodynamic energy to the patients.