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Impact of Pulsatile Flow on Hemodynamic Energy in a M edos D eltastream DP 3 Pediatric Extracorporeal Life Support System
Author(s) -
Krawiec Conrad,
Wang Shigang,
Kunselman Allen R.,
Ündar Akif
Publication year - 2014
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/aor.12117
Subject(s) - pulsatile flow , hemodynamics , extracorporeal , medicine , hematocrit , blood flow , cardiology , anesthesia
Abstract The M edos D eltastream DP 3 system is made up of a novel diagonal pump and hollow‐membrane oxygenator that provides nonpulsatile and pulsatile flows for extracorporeal life support ( ECLS ). The objectives of this study are to (i) evaluate the efficacy of the hemodynamic energy provided by M edos D eltastream DP 3 system in nonpulsatile and pulsatile mode and (ii) to evaluate the pulsatile mode under different frequencies. The experimental ECLS circuit was used in this study, primed with Ringer's lactate and packed red blood cells (hematocrit 35%). All trials were conducted at flow rates of 500, 1000, 1500, and 2000 mL/min with modified pulsatile frequencies of 60, 70, 80, and 90 bpm at 36°C. Simultaneous blood flow and pressures at the pre/postoxygenator and pre/postcannula sites were recorded for quantification of the pulsatile perfusion‐generated energy‐equivalent pressure ( EEP ), surplus hemodynamic energy ( SHE ), and total hemodynamic energy ( THE ). The experiments showed that under pulsatile flow conditions, at all flow rates and frequencies, (i) the EEP , SHE , and THE were significantly higher when compared with the nonpulsatile group and (ii) the pressure drop was minimal at lower flow rates and lower pulsatile frequencies but was significant when either the flow rate or the pulsatile frequency was increased. The M edos D eltastream DP 3 System can provide nonpulsatile flow and physiologic quality pulsatile flow for pediatric ECLS . When the Medos DP 3 pediatric ECLS system is used with pulsatile flow, there is more surplus hemodynamic energy and total hemodynamic energy than nonpulsatile flow.