Evaluation of Conventional Nonpulsatile and Novel Pulsatile Extracorporeal Life Support Systems in a Simulated Pediatric Extracorporeal Life Support Model

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.