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.

机械循环支持正在成为一种重要的治疗选择，既可以作为心脏移植的桥梁，也可以永久使用。正在开发几种类型的非脉动流泵用于长期循环支持，与脉动泵相比具有紧凑和低成本的优点。然而，长期非搏动性心室支持的病理生理学尚不清楚，连续流泵的控制方法，特别是在双心室辅助中的非搏动性流泵的控制方法尚未建立。本文对非脉动流泵辅助双心室的控制方法进行了基础性研究。连续流泵心室辅助下的血流动力学是非常特殊的，包括动脉搏动的减少。我们首先评估了非脉冲流泵心室辅助的生理变化。我们发现，全身性收缩功能的减弱和心脏副交感神经活动的进展。中枢神经系统、压力感受器功能、激素因子、肺系统无明显变化。提出了利用驱动电机电流实现连续流VAD优化运行的控制策略。电机电流和流速之间的良好相关性使我们能够检测到不利的泵送条件，例如流入插管抽吸，甚至通过VAD估计辅助状态。还检查了用于双心室支持的连续流泵的控制。通过调节右泵的流体动力学特性，试图维持左泵和右泵之间的循环平衡。使用流出管路的附加阻力可以成功地减少由循环阻力变化引起的流速波动。右泵的流速通过该装置稳定。

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）。

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。

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）。

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。