Comparison of six pediatric cardiopulmonary bypass pumps during pulsatile and nonpulsatile perfusion

Ündar, Akif; Eichstaedt, Harald C.; Masai, Takafumi; Yang, Su‐Jau; Bigley, Joyce E.; McGarry, Mary Claire; Mueller, M.; Vaughn, William K.; Fraser, Charles D.

doi:10.1067/mtc.2001.114931

Cited by 56 publications

(52 citation statements)

References 10 publications

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“…Due to technical limitations and several damping components such as the oxygenator and arterial filter, the properties of pulsatile flow used in the clinical setting are far from the ones of physiological pulsatile flow [9,10]. The fundamental problem of comparing the different perfusion modes or different types of pulsatile flow is the lack of a clear definition or a precise quantification of pulsatility.…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary bypass with physiological flow and pressure curves: pulse is unnecessary!☆

Voß

Krane

Jung

et al. 2010

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Cardiopulmonary bypass with physiological flow and pressure curves: pulse is unnecessary!☆

Voß

Krane

Jung

et al. 2010

European Journal of Cardio-Thoracic Surgery

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“…4 These results clearly suggest that pulsatile perfusion with a physiologic pulsatile pump generates significantly higher hemodynamic energy than a non-pulsatile roller pump. 4 This extra energy is transmitted in all directions, which improves red cell flow, plasma flow and lymphatic flow. 5 Several investigators have demonstrated that pulsatile flow reduces systemic vascular resistance and attenuates the catecholamine response 6 and hypothyroidism 7 and also improves splanchnic perfusion, 8 myocardial blood flow 9 and clinical outcome 6 -10 after cardiopulmonary bypass.…”

Section: Discussionmentioning

confidence: 79%

“…3 Recently, a new approach for a comparative study between non-pulsatile and pulsatile support was suggested for precise quantification of pressure-flow waveforms. 1,2,4 Ündar et al documented that the difference between Shepard's energy equivalent pressure (EEP) formula and pre-cannula extracorporeal circuit pressure is 45% when using a physiologic pulsatile pump. 4 These results clearly suggest that pulsatile perfusion with a physiologic pulsatile pump generates significantly higher hemodynamic energy than a non-pulsatile roller pump.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,4 Ündar et al documented that the difference between Shepard's energy equivalent pressure (EEP) formula and pre-cannula extracorporeal circuit pressure is 45% when using a physiologic pulsatile pump. 4 These results clearly suggest that pulsatile perfusion with a physiologic pulsatile pump generates significantly higher hemodynamic energy than a non-pulsatile roller pump. 4 This extra energy is transmitted in all directions, which improves red cell flow, plasma flow and lymphatic flow.…”

Section: Discussionmentioning

confidence: 99%

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Initial European Clinical Experience With Pulsatile Extracorporeal Membrane Oxygenation

Agati

Mignosa

Ciccarello

et al. 2006

The Journal of Heart and Lung Transplantation

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“…Flow pulsatility has been shown to be beneficial for organ perfusion [27] as well as healthy vascular gene expression and remodelling; however, the energetic cost of delivering a constant CO is higher in pulsatile flow than in non-pulsatile flow [26,72]. In the healthy circulatory system, the pulsatile component of ventricular load operates optimally and constitutes a small fraction of the total power requirement of the ventricle (approx.…”

Section: Non-dimensional Numbers In the Clinical Settingmentioning

confidence: 99%

Non-dimensional physics of pulsatile cardiovascular networks and energy efficiency

Yigit

Pekkan

2016

J. R. Soc. Interface.

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In Nature, there exist a variety of cardiovascular circulation networks in which the energetic ventricular load has both steady and pulsatile components. Steady load is related to the mean cardiac output (CO) and the haemodynamic resistance of the peripheral vascular system. On the other hand, the pulsatile load is determined by the simultaneous pressure and flow waveforms at the ventricular outlet, which in turn are governed through arterial wave dynamics (transmission) and pulse decay characteristics (windkessel effect). Both the steady and pulsatile contributions of the haemodynamic power load are critical for characterizing/comparing disease states and for predicting the performance of cardiovascular devices. However, haemodynamic performance parameters vary significantly from subject to subject because of body size, heart rate and subject-specific CO. Therefore, a 'normalized' energy dissipation index, as a function of the 'non-dimensional' physical parameters that govern the circulation networks, is needed for comparative/ integrative biological studies and clinical decision-making. In this paper, a complete network-independent non-dimensional formulation that incorporates pulsatile flow regimes is developed. Mechanical design variables of cardiovascular flow systems are identified and the Buckingham Pi theorem is formally applied to obtain the corresponding non-dimensional scaling parameter sets. Two scaling approaches are considered to address both the lumped parameter networks and the distributed circulation components. The validity of these non-dimensional number sets is tested extensively through the existing empirical allometric scaling laws of circulation systems. Additional validation studies are performed using a parametric numerical arterial model that represents the transmission and windkessel characteristics, which are adjusted to represent different body sizes and non-dimensional haemodynamic states. Simulations demonstrate that the proposed nondimensional indices are independent of body size for healthy conditions, but are sensitive to deviations caused by off-design disease states that alter the energetic load. Sensitivity simulations are used to identify the relationship between pulsatile power loss and non-dimensional characteristics, and optimal operational states are computed.

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Comparison of six pediatric cardiopulmonary bypass pumps during pulsatile and nonpulsatile perfusion

Cited by 56 publications

References 10 publications

Cardiopulmonary bypass with physiological flow and pressure curves: pulse is unnecessary!☆

Cardiopulmonary bypass with physiological flow and pressure curves: pulse is unnecessary!☆

Initial European Clinical Experience With Pulsatile Extracorporeal Membrane Oxygenation

Non-dimensional physics of pulsatile cardiovascular networks and energy efficiency

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