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. 2023 May;47(5):828-839.
doi: 10.1111/aor.14439. Epub 2022 Nov 14.

Improving adult pulsatile minimal invasive extracorporeal circulation in a mock circulation

Anke Dürr  1 , Elena Weber  1 , Lisa Eisenmann  1 , Günter Albrecht  1 , Andreas Liebold  1 , Markus Hoenicka  1
Affiliations

Improving adult pulsatile minimal invasive extracorporeal circulation in a mock circulation

Anke Dürr et al. Artif Organs. 2023 May.

Abstract

Background: Pulsatile extracorporeal circulation (ECC) may improve perfusion of critical organs during cardiac surgery. This study analyzed the influence of the components of a minimal invasive ECC (MiECC) on the transfer of pulsatile energy into the pseudo-patient of a mock circulation.

Methods: An aortic model with human-like geometry and compliance was perfused by a diagonal pump. Surplus hemodynamic energy (SHE) was determined from flow and pressure data. Five adult-size oxygenator models and three sizes of cannulas were compared. Pulsatile pump settings were optimized, and parallel dual-pump configurations were evaluated.

Results: Oxygenator models showed up to twofold differences in pressure gradients and influenced SHE at flow rates up to 2.0 L min-1 . Adjustments of frequency, systole duration, and rotational speed gain significantly improved SHE compared with empirical settings, with SHE above 21% of mean arterial pressure at flow rates of 1.0 L min-1 to 1.5 L min-1 and SHE above 5% at 3.5 L min-1 . Small diameter cannula (15 Fr) limited SHE compared with larger cannula (21 Fr and 23 Fr). Two diagonal pumps did not provide higher SHE than a single pump, but permitted additional control over pulse pressure and SHE by varying the total fraction of pulsatile flow and the fraction of flow bypassing the oxygenator.

Conclusions: Proper selection of components and optimizations of pump settings significantly improved pulse pressure and SHE of pulsatile MiECC. Surplus hemodynamic energy depended on flow rate with a maximum at 1.0 L min-1 -1.5 L min-1 . Pulsatile MiECC may specifically assist organ perfusion during phases of low flow.

Keywords: cannula; diagonal pump; minimal invasive extracorporeal circulation; oxygenator; pulsatile perfusion; surplus hemodynamic energy.

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References

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