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Evaluation of Conventional Nonpulsatile and Novel Pulsatile Extracorporeal Life Support Systems in a Simulated Pediatric Extracorporeal Life Support Model
Author(s) -
Wang Shigang,
Evenson Alissa,
Chin Brian J.,
Kunselman Allen R.,
Ündar Akif
Publication year - 2015
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.12290
Subject(s) - pulsatile flow , oxygenator , extracorporeal , hemodynamics , medicine , cannula , biomedical engineering , centrifugal pump , cardiopulmonary bypass , materials science , anesthesia , cardiology , surgery , mechanics , physics , impeller
The objective of this study is to evaluate two extracorporeal life support ( ECLS ) circuits and determine the effect of pulsatile flow on pressure drop, flow/pressure waveforms, and hemodynamic energy levels in a pediatric pseudopatient. One ECLS circuit consisted of a M edos D eltastream DP 3 diagonal pump and H ilite 2400 LT oxygenator with arterial/venous tubing. The second circuit consisted of a M aquet R ota F low centrifugal pump and Q uadrox‐i D P ediatric oxygenator with arterial/venous tubing. A 14 F r M edtronic B io‐ M edicus one‐piece pediatric arterial cannula was used for both circuits. All trials were conducted at flow rates ranging from 500 to 2800 mL/min using pulsatile or nonpulsatile flow. The post‐cannula pressure was maintained at 50 mm Hg. Blood temperature was maintained at 36°C. Real‐time pressure and flow data were recorded using a custom‐based data acquisition system. The results showed that the D eltastream DP 3 circuit produced surplus hemodynamic energy ( SHE ) in pulsatile mode at all flow rates, with greater SHE delivery at lower flow rates. Neither circuit produced SHE in nonpulsatile mode. The D eltastream DP 3 pump also demonstrated consistently higher total hemodynamic energy at the pre‐oxygenator site in pulsatile mode and a lesser pressure drop across the oxygenator. The D eltastream DP 3 pump generated physiological pulsatility without backflow and provided increased hemodynamic energy. This novel ECLS circuit demonstrates suitable in vitro performance and adaptability to a wide range of pediatric patients.