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PreLoad-responsive, Pulsatile-Flow, Externally Valved Pump: Cardiopulmonary Bypass

 

作者: RungeThomas M.,   GroverFrederick L.,   CohenDavid J.,   BohlsFrederick O.,   OttmersStephen E.,  

 

期刊: Journal of Investigative Surgery  (Taylor Available online 1989)
卷期: Volume 2, issue 3  

页码: 269-279

 

ISSN:0894-1939

 

年代: 1989

 

DOI:10.3109/08941938909057433

 

出版商: Taylor&Francis

 

关键词: Pulsatile bypass;preload-responsive pump;externally valved pump

 

数据来源: Taylor

 

摘要:

Currently two pumps are used for cardiopulmonary bypass, the roller pump and the centrifugal or vortex pump. Both are steady-flow pumps. The procedure of cardiopulmonary bypass possesses a finite morbidity and mortality. The degree to which steady flow is responsible for this morbidity and mortality remains to be clarified, but investigators have established the fact that a physiologic degree of pulsatile flow must be achieved before its beneficial results, such as normal systemic resistance and absence of lactate production, can be demonstrated. Availability of a satisfactory pulsatile pump for cardiopulmonary bypass has been a problem in the past but the pump presented here may satisfy this need. It produces physiologic pulsatility with rate dependent ejection time equal to or less than that of humans (413µs minus 1.7 times heart rate), and it is preload-responsive, varying its pumping rate and output with filling pressure. The pump is externally valved to minimize hemolysis, which has been demonstrated in two laboratory studies to be significantly less than with the roller pump. It produces pulsatile flow through membrane oxygenators. The pump is thought to have potential for several clinical applications in addition to (I) pulsatile-flow cardiopulmonary bypass, including (2) left, right, or combined transthoracic QRS synchronized ventricular assist, (3) femoral vein to femoral artery QRS synchronized left ventricular assist, (4) adult or infant ECMO, (5) pulsatile flow hemodialysis. In the latter, spallation and embolization of hemodialysis tubing particles should not be a problem as has proved to be the case with the present hemodialysis Pump.

 

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