Evaluation of centrifugal blood pumps in term of hemodynamic performance using simulated neonatal and pediatric ECMO circuits

Abstract

The objective of this translational study was to evaluate the FDA‐approved PediMag, CentriMag, and RotaFlow centrifugal blood pumps in terms of hemodynamic performance using simulated neonatal and pediatric extracorporeal membrane oxygenation (ECMO) circuits with different sizes of arterial and venous cannulae. Cost of disposable pump heads was another important variable for this particular study. The experimental circuit was composed of one of the centrifugal pump heads, a polymethylpentene membrane oxygenator, neonatal and pediatric arterial/venous cannulae, and 1/4‐inch ID tubing. Circuits were primed with lactated Ringer’s solution and packed human red blood cells (hematocrit 35%). Trials were conducted at 36°C using the three pump heads and different cannulae (arterial/venous cannulae: 8 Fr/18 Fr, 10 Fr/20 Fr, and 12 Fr/22 Fr) at various flow rates (200–2400 mL/min, 200 mL/min increments) and rotational speeds. Pseudo patient pressure was 60 mm Hg. Real‐time pressure and flow data were recorded for analysis. The RotaFlow pump had a higher pressure head and flow range compared with the PediMag and CentriMag pumps at the same rotational speed and identical experimental settings (P < 0.001). The PediMag pump had lower flow output than others (P < 0.001). Small‐caliber arterial cannulae and higher flow rates predictably created higher circuit pressures and pressure drops. There was no significant difference in hemodynamic energy delivered to the pseudo patient with each of the three pumps. The arterial cannula had the highest pressure drop and hemodynamic energy loss in the circuit when compared to the oxygenator and arterial tubing. The RotaFlow centrifugal pump had a significantly better hemodynamic performance when compared to the PediMag and CentriMag blood pumps at identical experimental conditions in simulated neonatal and pediatric ECMO settings. In addition, the cost of the RotaFlow pump head ($400) is 20 to 30‐fold less than the other centrifugal pumps [CentriMag ($12 000) or PediMag ($8000)] that were evaluated in this translational study.

Clinical outcomes of neonatal and pediatric extracorporeal life support: A seventeen‐year, single institution experience

“…Penn State Health Children’s Hospital, a quaternary care Children’s Hospital, located in south central Pennsylvania, has been performing neonatal and pediatric ECLS for 26 years. A multidisciplinary team evaluates the technical performance of current and new circuit components to potentially reduce circuit‐related complications . The purpose of this study was to characterize the ECLS population at the PSHCH and compare complications and survival outcomes to those of the ELSO Registry.…”

“…A multidisciplinary team evaluates the technical performance of current and new circuit components to potentially reduce circuit-related complications. [5][6][7][8][9][10][11][12] The purpose of this study was to characterize the ECLS population at the PSHCH and compare complications and survival outcomes to those of the ELSO Registry.…”

Antibiotics and ECMO in the Adult Population—Persistent Challenges and Practical Guides

“…There are two main types of pumps: roller and centrifugal [29]. The latter confers the advantage of minimized shear stress exerted upon erythrocytes [37,38]. The pump suctions venous blood from the patient, and a bladder may be introduced in front of the pump to prevent excessive negative pressure and venous collapse.…”

Centrifugal Pump Generates Superior Hemodynamic Performance Compared to a new Diagonal Blood Pump in Neonatal and Pediatric ECMO Circuits

“…Furthermore, significantly better hemodynamic performance was observed for the RotaFlow centrifugal pump when compared to the CentriMag centrifugal pump under identical experimental conditions in simulated neonatal and pediatric ECMO settings. 6 In addition to the comparison of the RotaFlow and CentriMag centrifugal pumps, this particular study 6 also evaluated the DP3-i-cor diagonal pump using identical experimental conditions under pulsatile and non-pulsatile modes. However, the article did not make any direct comparisons between the centrifugal pump and the diagonal pump.…”