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Improving adult pulsatile minimal invasive extracorporeal circulation in a mock circulation.
Dürr, Anke; Weber, Elena; Eisenmann, Lisa; Albrecht, Günter; Liebold, Andreas; Hoenicka, Markus.
Afiliação
  • Dürr A; Department of Cardiothoracic and Vascular Surgery, Ulm University Medical Center, Ulm, Germany.
  • Weber E; Department of Cardiothoracic and Vascular Surgery, Ulm University Medical Center, Ulm, Germany.
  • Eisenmann L; Department of Cardiothoracic and Vascular Surgery, Ulm University Medical Center, Ulm, Germany.
  • Albrecht G; Department of Cardiothoracic and Vascular Surgery, Ulm University Medical Center, Ulm, Germany.
  • Liebold A; Department of Cardiothoracic and Vascular Surgery, Ulm University Medical Center, Ulm, Germany.
  • Hoenicka M; Department of Cardiothoracic and Vascular Surgery, Ulm University Medical Center, Ulm, Germany.
Artif Organs ; 47(5): 828-839, 2023 May.
Article em En | MEDLINE | ID: mdl-36310392
BACKGROUND: Pulsatile extracorporeal circulation (ECC) may improve perfusion of critical organs during cardiac surgery. This study analyzed the influence of the components of a minimal invasive ECC (MiECC) on the transfer of pulsatile energy into the pseudo-patient of a mock circulation. METHODS: An aortic model with human-like geometry and compliance was perfused by a diagonal pump. Surplus hemodynamic energy (SHE) was determined from flow and pressure data. Five adult-size oxygenator models and three sizes of cannulas were compared. Pulsatile pump settings were optimized, and parallel dual-pump configurations were evaluated. RESULTS: Oxygenator models showed up to twofold differences in pressure gradients and influenced SHE at flow rates up to 2.0 L min-1 . Adjustments of frequency, systole duration, and rotational speed gain significantly improved SHE compared with empirical settings, with SHE above 21% of mean arterial pressure at flow rates of 1.0 L min-1 to 1.5 L min-1 and SHE above 5% at 3.5 L min-1 . Small diameter cannula (15 Fr) limited SHE compared with larger cannula (21 Fr and 23 Fr). Two diagonal pumps did not provide higher SHE than a single pump, but permitted additional control over pulse pressure and SHE by varying the total fraction of pulsatile flow and the fraction of flow bypassing the oxygenator. CONCLUSIONS: Proper selection of components and optimizations of pump settings significantly improved pulse pressure and SHE of pulsatile MiECC. Surplus hemodynamic energy depended on flow rate with a maximum at 1.0 L min-1 -1.5 L min-1 . Pulsatile MiECC may specifically assist organ perfusion during phases of low flow.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Oxigenação por Membrana Extracorpórea Limite: Adult / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Oxigenação por Membrana Extracorpórea Limite: Adult / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article