Multifunctional VAD Technology for High-Risk Pediatric Patients

项目总结 这一多样性补充申请促进了合格候选人的发展和过渡到 作为临床医生和学术研究人员的长期职业生涯的高级医学博士/博士课程。 这项提案中的研究将侧重于研究非搏动性血流对脑脊液的影响 接受机械循环支持(MCS)的患者的液体(CSF)动力学。她经验丰富的导师是 艾米·索罗克莫顿博士(MCS生物医学工程师)，德雷克塞尔大学。她已经收集了一份建议 该委员会由心血管生理学、计算模型、 脑血流动力学、脑脊液动力学、神经外科和MCS；因此，她将发展 并完善她在这些领域的专业知识。她还将获得网络、技术写作、 多物理建模、研究伦理、儿科学和心胸外科。候选人得到了 在德雷塞尔大学、托马斯·杰斐逊大学和大学拥有杰出的机构资源。特拉华州。 对连续流(CF)MCS和MCS之间的交换了解有限 脑脊液(CSF)动力学。研究已经证明了CF-MCS的临床益处，但有以下几点 还有挑战，如血栓栓塞症(中风)事件。到目前为止，研究工作主要集中在 降低中风风险，而CF-MCS对脑脊液流动物理的影响尚未被研究。流动 脑脊液的紊乱被认为是神经病理生理学的一部分。MCS领域也是 现在转向使用更紧凑、血栓形成较少、无脉搏的CF设备。 这些方面强调了尚未满足的临床需求，即探索中风和中风以外的神经风险 检查CF-MCS对脑脊液动力学的生理学后果和放大的神经学风险 减损。这项研究的长期目标是建立我们对病理生理学的理解 CF-MCS对脑脊液动力学的影响。强有力的前期工作表明有证据表明脑脊液异常 在CF-MCS期间的动态。因此，我们的中心假设是CF-MCS患者的CF会导致 脉压降低或消失，导致脉动性脑脊液流量减少。这一假设将是 进一步检验这些目标：1)建立心血管、脑和脑脊液的计算框架 2)研究了CFMCS对脑脊液物理特性的影响。这项研究将推动我们的 了解CF-MCS，并使我们能够设计新的创新解决方案来降低神经学风险 CF-MCS术中并发症。候选人打算继续把她的努力集中在改善 在她攻读医学博士学位期间和在她的临床过程中，都有心血管治疗方案 研究。从本计划书中的培训中获得的经验和技能将使候选人能够 成功地继续努力，增强了自己的能力，为推进 医学领域。

PROJECT SUMMARY This Diversity Supplement application promotes the qualified candidate’s development and transition to a high-ranking M.D./Ph.D. program toward a long-term career as a clinician and academic researcher. Research in this proposal will focus on the investigating the impact of non-pulsatile blood flow on cerebrospinal fluid (CSF) dynamics in patients who receive mechanical circulatory support (MCS). Her experienced mentor is Amy Throckmorton, PhD (MCS biomedical engineer) at Drexel University. She has assembled an Advisory Committee that is comprised of renowned researchers in cardiovascular physiology, computational modeling, cerebral hemodynamics, cerebrospinal fluid (CSF) dynamics, neurosurgery, and MCS; thus, she will develop and refine her expertise in these fields. She will also gain skills and knowledge in networking, technical writing, multi physics modeling, research ethics, pediatrics, and cardiothoracic surgery. The candidate is supported by outstanding institutional resources at Drexel University, Thomas Jefferson University, and Univ. of Delaware. There is limited understanding of the interchange between continuous-flow (CF) MCS and cerebrospinal fluid (CSF) dynamics. Studies have demonstrated clinical benefits from CF-MCS, but there are also challenges, such as thromboembolic (stroke) events. Research efforts to-date have concentrated on mitigating stroke risk, and the impact of CF-MCS on the CSF flow physics has not been investigated. Flow disturbances in the CSF are recognized to contribute to neurologic pathophysiology. The field of MCS is also now pivoting toward the use of more compact, less thrombogenic, non-pulsatile CF devices. These aspects emphasize the unmet clinical need of exploring the neurologic risk beyond stroke and examining the physiologic consequences of CF-MCS on CSF dynamics and the amplified risk of neurologic impairment. The long-term goal of this research is to build our understanding of the pathophysiologic consequences of CF-MCS on CSF dynamics. Strong prior work demonstrates evidence of abnormal CSF dynamics during CF-MCS. Thus, our central hypothesis is that CF in a patient with CF-MCS leads to a diminished or absent pulse pressure, which produces decreased pulsatile CSF flow. This hypothesis will be further tested in these Aims: 1) establish a computational framework of cardiovascular, cerebral and CSF fluid dynamics; and 2) characterize the impact of CF-MCS on the CSF physics. This research will advance our understanding of CF-MCS and enable us to devise new innovative solutions to mitigate the risk of neurologic complications during CF-MCS. The candidate intends to continue focusing her efforts on the improvement of cardiovascular therapeutic solutions both during her pursuit of an M.D./Ph.D. and throughout her clinical research. The experience and skills gained from the training in this proposal will allow the candidate to successfully continue these efforts, bolstering her ability make significant contributions towards advancing the field of medicine.