Preliminary experimental study about the feasibility of combining pulsatile cardiopulmonary support system and a membrane oxygenator. 1996

T Nakazawa, and M Shiono, and T Inoue, and Y Orime, and S Shindo, and Y Sezai
Second Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.

A cardiopulmonary support (CPS) device that incorporated a pneumatic ventricular assist device (VAD) and a membrane oxygenator was developed for the support of patients with profound heart and/or respiratory failure. This device has an advantage of being both a pulsatile assist device and membrane oxygenator. A "triple flow" regulator was included in this system to control the blood flow through the oxygenator. The purpose of this study was to clarify the efficacy of this system in supporting an animal model with combined cardiac and respiratory failure. In vitro tests showed 3.7 L/min of pump flow under 1.6 L/min of oxygen supply to the oxygenator even though there was a 50% clamp of a "triple flow" regulator with sufficient pulsatility. In 14 acute canine experiments, cardiogenic shock and acute respiratory failure were introduced by coronary ligation and mechanical hypoventilation simultaneously. The pump flow was maintaned at 1.95-0.6 L/min (average 1.2 L/min) and the driving pressure of the pump was controlled between 200 and 300 mmHg positive pressure and -20 to -50 mmHg negative pressure. The driving rate was fixed at 100 bpm and systolic/diastolic ratio was controlled between 35-50%. The canines were divided into control group (n = 4) and pumped group (drained from the right atrium n = 7, drained from the left atrium n = 3). By using CPS system, flow and aortic pressure recovered to the initial baseline level. Without this support, the canine model could not maintain systemic circulation. In the group drained from right atrium, central venous pressure decreased with the device from 13.9 +/- 2.4 to 5.6 +/- 1.4 cm H2O (p < 0.01), returned to the initial level without this device (p < 0.01). In the group drained from left atrium, pulmonary capillary wedge pressure decreased from 37.9 +/- 4.6 to 20.8 +/- 5.7 mmHG (p < 0.01), and returned to the initial level without the device, arterial oxygen tension levels increased tension levels increased (p < 0.01), and also arterial oxygen saturation levels recovered (p < 0.01). The results suggest that the current model of the pulsatile CPS has a potential to support the animal model with combined cardiac and respiratory failure.

UI MeSH Term Description Entries
D010101 Oxygen Consumption The rate at which oxygen is used by a tissue; microliters of oxygen STPD used per milligram of tissue per hour; the rate at which oxygen enters the blood from alveolar gas, equal in the steady state to the consumption of oxygen by tissue metabolism throughout the body. (Stedman, 25th ed, p346) Consumption, Oxygen,Consumptions, Oxygen,Oxygen Consumptions
D010107 Oxygenators, Membrane Devices in which blood and oxygen are separated by a semipermeable membrane, generally of Teflon or polypropylene, across which gas exchange occurs. The membrane may be arranged as a series of parallel plates or as a number of hollow fibers; in the latter arrangement, the blood may flow inside the fibers, which are surrounded by gas, or the blood may flow outside the fibers and the gas inside the fibers. (Dorland, 28th ed) Membrane Oxygenator,Membrane Oxygenators,Oxygenator, Membrane
D011669 Pulmonary Wedge Pressure The blood pressure as recorded after wedging a CATHETER in a small PULMONARY ARTERY; believed to reflect the PRESSURE in the pulmonary CAPILLARIES. Pulmonary Artery Wedge Pressure,Pulmonary Capillary Wedge Pressure,Pulmonary Venous Wedge Pressure,Wedge Pressure,Pressure, Pulmonary Wedge,Pressures, Pulmonary Wedge,Pulmonary Wedge Pressures,Wedge Pressure, Pulmonary,Wedge Pressures, Pulmonary,Pressure, Wedge,Pressures, Wedge,Wedge Pressures
D011673 Pulsatile Flow Rhythmic, intermittent propagation of a fluid through a BLOOD VESSEL or piping system, in contrast to constant, smooth propagation, which produces laminar flow. Flow, Pulsating,Perfusion, Pulsatile,Flow, Pulsatile,Flows, Pulsatile,Flows, Pulsating,Perfusions, Pulsatile,Pulsatile Flows,Pulsatile Perfusion,Pulsatile Perfusions,Pulsating Flow,Pulsating Flows
D012131 Respiratory Insufficiency Failure to adequately provide oxygen to cells of the body and to remove excess carbon dioxide from them. (Stedman, 25th ed) Acute Hypercapnic Respiratory Failure,Acute Hypoxemic Respiratory Failure,Hypercapnic Acute Respiratory Failure,Hypercapnic Respiratory Failure,Hypoxemic Acute Respiratory Failure,Hypoxemic Respiratory Failure,Respiratory Depression,Respiratory Failure,Ventilatory Depression,Depressions, Ventilatory,Failure, Hypercapnic Respiratory,Failure, Hypoxemic Respiratory,Failure, Respiratory,Hypercapnic Respiratory Failures,Hypoxemic Respiratory Failures,Respiratory Failure, Hypercapnic,Respiratory Failure, Hypoxemic,Respiratory Failures
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D004195 Disease Models, Animal Naturally-occurring or experimentally-induced animal diseases with pathological processes analogous to human diseases. Animal Disease Model,Animal Disease Models,Disease Model, Animal
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D005240 Feasibility Studies Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project. Feasibility Study,Studies, Feasibility,Study, Feasibility
D006353 Heart-Assist Devices Small pumps, often implantable, designed for temporarily assisting the heart, usually the LEFT VENTRICLE, to pump blood. They consist of a pumping chamber and a power source, which may be partially or totally external to the body and activated by electromagnetic motors. Artificial Ventricle,Heart Assist Device,Heart Ventricle, Artificial,Pumps, Heart-Assist,Vascular-Assist Device,Vascular-Assist Devices,Ventricle-Assist Device,Ventricular Assist Device,Artificial Heart Ventricle,Artificial Heart Ventricles,Artificial Ventricles,Assist Device, Heart,Assist Device, Ventricular,Assist Devices, Heart,Assist Devices, Ventricular,Device, Heart Assist,Device, Heart-Assist,Device, Vascular-Assist,Device, Ventricle-Assist,Device, Ventricular Assist,Devices, Heart Assist,Devices, Heart-Assist,Devices, Vascular-Assist,Devices, Ventricle-Assist,Devices, Ventricular Assist,Heart Assist Devices,Heart Ventricles, Artificial,Heart-Assist Device,Heart-Assist Pump,Heart-Assist Pumps,Pump, Heart-Assist,Pumps, Heart Assist,Vascular Assist Device,Vascular Assist Devices,Ventricle Assist Device,Ventricle, Artificial,Ventricle, Artificial Heart,Ventricle-Assist Devices,Ventricles, Artificial,Ventricles, Artificial Heart,Ventricular Assist Devices

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