Basic research concerning control method of bi-ventricular assist with nonpulsatile flow pump

非脉动流泵双心室辅助控制方法基础研究

• 批准号: 11557102
• 负责人: TAKANO Hisateru
• 金额: $ 7.74万
• 依托单位: National Cardiovascular Center Research Institute
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 1999
• 资助国家: 日本
• 起止时间: 1999 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-11557102/
• 关键词: Artificial heart; nonpulsatile flow pump; Continuous flow; biventricular support; Control; Motor Current; 両心補助循環; 流量制御; 脳; 代謝; 電流; 心室細動

Mechanical circulatory support is becoming an important therapeutic option both as a bridge to heart transplantation and for permanent use. Several types of nonpulsatile flow pumps are being developed for long-term circulatory support, having the advantage of compactness and low cost as compared to pulsatile pumps. The pathophysioloey of long-term nonpulsatile ventricular support, however, is not yet clearly understoocL The control method of continuous flow pumps especially in bi-ventncular assist with nonpulsatile flow pump has not been established. We have attempted basic research concerning control method of bi-ventricular assist with nonpulsatile flow pump. The hemodynamics under ventricular assist with continuous flow pump is quite particular including reduction in arterial pulsatility. We firstly evaluated physiological changes due to ventricular assist with the nonpusatile flow pump. We found that the diminution of systemic yasoconstrictive function and progression of cardiac parasympathetic nervous activity. However no obvious changes were not observed in central nervous system, baroreceptor function, hormonal factors, and pulmonary system. The control tactics for the optimized operation of a continuous-flow VAD using the driving motor current has been proposed. The good correlation between the motor current and flow rate allowed us to detect adverse pumping condition such as inflow cannulae sucking and even to estimate assist status by the VAD. The control of the continuous-flow pumps for biventricular support has also been examined. Maintenance of the circulatory balance between the left and the right pump was attempted by adjusting the hydrodynamic characteristics of the rignt pump. Use of additional resistance of the outflow tubing could successfully reduce the flow rate fluctuation caused by the change in circulatory resistance. The flow rate of the right pump was stabilized by this device.

机械循环支持已成为重要的治疗选择，既是心脏移植的桥梁，也可以永久使用。与脉动泵相比，正在开发几种类型的非乳化流动泵，以用于长期循环支持，具有紧凑性和低成本的优势。然而，长期非脉冲心室支持的病理学尚未清楚地识别连续流动泵的控制方法，尤其是在双通孔辅助辅助非脉冲流动泵中的控制方法。我们尝试了基础研究，涉及双腹膜辅助非脉冲流动泵的控制方法。连续流动泵的心室辅助下的血液动力学特别是降低动脉搏动性。我们首先评估了由于心室辅助非抑制流动泵而导致的生理变化。我们发现，系统性yasoctrictigation功能和心脏副交感神经活动的进展减少。然而，在中枢神经系统，压力感受器功能，荷尔蒙因子和肺系统中未观察到明显的变化。已经提出了使用驱动电动机电流进行连续流动VAD进行优化操作的控制策略。电机电流和流速之间的良好相关性使我们能够检测出不利的抽水条件，例如流入插管吮吸，甚至可以通过VAD估算辅助状态。还检查了对连续流动泵进行双脑室支撑的控制。通过调整Rignt Pump的流体动力特性，尝试维护左和右泵之间的循环平衡。流出管道的额外电阻可以成功减少循环阻力变化引起的流速波动。该设备稳定了右泵的流速。

项目成果

Nishinaka T., Tatsumi E., Nishimura T.et al.: "Cardiac autonomic nervous function during long-term nonpulsatile left heart bypass"Artif Organs. 23・6. 500-503 (1999)

Nishinaka T.、Tatsumi E.、Nishimura T.等：“长期非搏动性左心搭桥期间的心脏自主神经功能”Artif Organs 23・6（1999）。

高野久輝: "体内植え込み型人工心臓開発の背景と現況"医科器械学. 69(7). 299-304 (1999)

Hisaki Takano：“植入式人工心脏的发展背景和现状”医疗仪器69（7）（1999）。

Nishinaka T, et al.: "Effect of prolonged nonpulsatile left heart bypass on vascular control status."J Artif Organs. 3(1). 34-38 (2000)

Nishinaka T 等人：“长期非搏动性左心搭桥对血管控制状态的影响。”J Artif Organs。

Nishinaka T., Tatsumi E., Nishimura T.et al.: "Change in vasoconstrictive function during prolonged non pulsatile left heart bypass"Artif Organs. 25・5. 371-375 (2001)

Nishinaka T.、Tatsumi E.、Nishimura T.et al.：“长时间非搏动性左心搭桥期间血管收缩功能的变化”Artif Organs 25・5（2001）。

Nishimura T., Tatsumi E., Nishinaka T. et al: "Prolonged nonpulsatile left heart bypass diminishes vascular comtractility"Int J Artif Organs. 22. 492-498 (1999)

Nishimura T.、Tatsumi E.、Nishinaka T. 等人：“延长非搏动性左心旁路可减少血管收缩性”Int J Artif Organs。