Premium
Control of the Total Artificial Heart: New Aspects in Human versus Animal Experience
Author(s) -
Schima Heinrich,
Trubel Wolfgang,
Coraim Farag,
Huber Leopold,
Müller Michael Rolf,
Redl Gerhard,
Losert Udo,
Thoma Herwig,
Wolner Ernst
Publication year - 1989
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/j.1525-1594.1989.tb01577.x
Subject(s) - hemodynamics , artificial heart , cardiac output , vascular resistance , medicine , blood pressure , cardiology , surgery
Control strategies for total artificial heart application have generally been based on experience with healthy animals. Human patients in a bad state of health who have impaired organ functions and who are subjected to intensive care procedures can develop atypical hemodynamic behavior. In these patients, both unstable and hyperstable behavior of the vascular resistance were observed. Therefore, regulation of cardiac output (CO) by pressure parameters only was avoided and CO was adjusted to obtain an appropriate O 2 ‐utilization (O 2 U). Intending to keep the O 2 U within ranges of 20–25%, we obtained cardiac indexes between 3.3 and 4.4 L/m 2 /min (CO 6–8 L/min), which is higher than other cardiac indexes reported. A CO of 10.5 L/min was even necessary to obtain an O 2 U of 30% in a septic patient. This strategy caused a stable driving management and led to a rapid hemodynamic stabilization and general improvement of the patients' condition. Results indicate that it is also very important to monitor metabolic parameters for appropriate driver adjustment as well, especially in the early postoperative phase, and that O 2 ‐U is a sensitive and useful parameter for this purpose.