Improving hemocompatibility in ventricular assist device therapy using physiological controlstrategies

使用生理控制策略改善心室辅助装置治疗的血液相容性

• 批准号: 409796053
• 负责人: Professor Dr.-Ing. Steffen Leonhardt
• 金额: --
• 依托单位: Lehrstuhl für Medizinische Informationstechnik (MedIT)
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2019
• 资助国家: 德国
• 起止时间: 2018-12-31 至 2023-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/409796053?language=en
• 关键词: Improving; hemocompatibility; ventricular; assist; device

Heart failure is one of the main causes of mortality in the developed world. Despite the rapid growth in the number of ventricular assist device (VAD) implantations in recent years, heart transplantation remains the gold standard therapy for terminal stage heart failure. Nevertheless, the number of transplanted hearts is significantly lower than the existing need. There is no expected solution to the problem of donor heart availability in the near future. The basic function of a VAD is to assist the heart in pumping blood from the left ventricle into the aorta. Most of todays available systems are based on rotary blood pumps (RBP) which are typically operated at either constant speed or constant flow. More advanced operating schemes aim at adapting blood flow to the time-variant demand of the cardiovascular system (CVS) and the changing performance of the heart. This requires the interaction between the CVS and the RBP, which can be achieved by a physiological controller. One of the main technical issues in building a VAD system is the minimization of hemolysis, the destruction of blood cells due to the exposure of blood to the artificial pumping mechanism. Much work has been dedicated in the past to optimize the geometry of the pumping mechanism as well as the conducting flow path in this respect. So far this has been mainly done in respect to static operating conditions, which never happens in a physiological context. Within the proposed project, we want to investigate if hemocompatibility can be improved by optimizing the dynamic control of the RBP. In order to achieve this, a model of hemolysis dependent on operating conditions has to be found. For this, we will use two alternative approaches. A data driven approach, where a mapping function is determined by parameter estimation from measurement data and a physics driven approach, where a computational fluid dynamics (CFD) simulation of the hydraulic system is used. In parallel to these activities, we will update our laboratory hybrid mock circulatory loop to facilitate hemocompatibility testing under a wide range of dynamic, physiological and pathological load conditions. Based on models and testing results, we will then develop control algorithms, which incorporate hemocompatibility as objective in a robust optimal control problem. Additionally, a pump flow estimator for the Sputnik VAD will be developed to support the dynamic operation and hemocompatibility performance. The optimized controller will be evaluated in dynamic close-to-physiology-testing in the hemocompatible mock circulatory loop using animal blood. The intended result of this project is an integrated pump system, which can not only provide the required hemodynamics but also decrease blood damage by using an optimal control strategy.

心力衰竭是发达国家死亡的主要原因之一。尽管近年来心室辅助装置（VAD）植入的数量迅速增长，但心脏移植仍然是终末期心力衰竭的金标准治疗方法。然而，移植心脏的数量远远低于目前的需求。在不久的将来，没有预期的解决办法来解决供体心脏的可用性问题。VAD的基本功能是帮助心脏将血液从左心室泵入主动脉。目前大多数可用的系统是基于旋转血泵（RBP），其通常以恒定速度或恒定流量操作。更先进的操作方案旨在使血流适应心血管系统（CVS）的时变需求和心脏性能的变化。这需要CVS和RBP之间的相互作用，这可以通过生理控制器来实现。构建VAD系统的主要技术问题之一是最小化溶血，即由于血液暴露于人工泵送机制而导致的血细胞破坏。在这方面，过去已经致力于许多工作来优化泵送机构的几何形状以及传导流动路径。到目前为止，这主要是在静态操作条件下完成的，这在生理环境中从未发生过。在所提出的项目中，我们希望研究是否可以通过优化RBP的动态控制来改善血液相容性。为了实现这一目标，必须找到取决于操作条件的溶血模型。为此，我们将使用两种替代方法。一种是数据驱动方法，其中映射函数是通过测量数据的参数估计来确定的，另一种是物理驱动方法，其中使用液压系统的计算流体动力学（CFD）模拟。在开展这些活动的同时，我们将更新我们的实验室混合模拟循环回路，以便于在广泛的动态、生理和病理负荷条件下进行血液相容性试验。基于模型和测试结果，我们将开发控制算法，将血液相容性作为目标，在一个强大的最优控制问题。此外，将开发Sputnik VAD的泵流量估计器，以支持动态操作和血液相容性性能。优化的控制器将在使用动物血液的血液相容性模拟循环回路中的动态接近生理学测试中进行评价。本项目的预期结果是一个集成的泵系统，它不仅可以提供所需的血液动力学，而且还可以通过使用最佳控制策略来减少血液损伤。