In vitro evaluation of automatic control performance of a total artificial heart with changes in pump orientation
In vitro evaluation of automatic control performance of a total artificial heart with changes in pump orientation
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DOI：
10.1097/00002480-199609000-00056
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发表时间：
1996-09-01
期刊：
影响因子：
4.2
通讯作者：
Kiraly, RJ
中科院分区：
文献类型：
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作者：
Fukamachi, K;Harasaki, H;Kiraly, RJ
与动物实验不同，全人工心脏（TAH）的泵方向在人体中会随着受者的姿势（直立、仰卧或俯卧）发生显著变化，从而影响其填充特性。Cleveland Clinic-Nimbus (CC-N) TAH的左主备用控制模式通过将左泵保持在90%填充来调节心率，产生类似Frank-Starling的预载灵敏度。为了验证CC-N TAH在不受重力影响的情况下是否能正常工作，我们在模拟人体仰卧（右上泵）和俯卧（左上泵）姿势的循环回路中评估了CC-N TAH的预载敏感性曲线。右泵上、下时，右侧预紧灵敏度略高；左泵上、下时，左侧预紧灵敏度略高。尽管重力对泵充液有影响，但左、右预负荷敏感性仍保持在生理范围内，CC-N TAH的自动控制功能正常，没有明显的姿势影响。
Unlike in animal experiments, the pump orientation of a total artificial heart (TAH) can change remarkably in humans with the recipient's posture (upright, supine, or prone), thus affecting its filling characteristics. The left master alternate control mode of the Cleveland Clinic-Nimbus (CC-N) TAH adjusts beat rate by maintaining the left pump at 90% filling, producing a Frank-Starling like preload sensitivity. In order to verify that the CC-N TAH functions properly regardless of the gravity effects on pump filling, the preload sensitivity curves of the CC-N TAH were evaluated on a mock circulatory loop with the simulated supine (right pump up) and prone (left pump up) positions in humans. The right preload sensitivity was slightly higher when the right pump was up versus down, and likewise the left preload sensitivity was higher when the left pump was up versus down. Despite these gravity effects on pump filling, right and left preload sensitivity remained within physiologic range and the automatic control of the CC-N TAH functioned properly without significant postural effects.