Hemodynamic evaluation of a new pulsatile blood pump during low flow cardiopulmonary bypass support

Background: Current blood pumps used for cardiopulmonary bypass generally fall into two different pump design categories; non-occlusive centrifugal pumps and occlusive, positive-displacement roller pumps. The amount of foreign surface area of extracorporeal circuits correlates with post-operative morbidity due to systemic inflammation, leading to a push for technology that reduces the amount of foreign surfaces. Current roller pumps are bulky and the tubing forms an arc in the pumping chamber (raceway), positioning the inlet 360 degrees from the outlet, making it very difficult to place the pump closer to the patient and to efficiently reduce tubing length. These challenges put existing roller pumps at a disadvantage for use in a compact cardiopulmonary bypass circuit. Centrifugal blood pumps are easier to incorporate into miniature circuit designs. However, the prime volumes of current centrifugal pump designs are large, especially for pediatric extracorporeal circuits where the prime volumes are too great to be of clinical value. Method: We describe a preliminary report on a novel, occlusive, linear, single-helix, positive-displacement blood pump which allows for decreased prime volume and surface area of the extracorporeal circuit. This new experimental pump design was used to perfuse a 6 kilogram piglet with a pediatric cardiopulmonary bypass circuit for two hours of continuous use. Blood samples were obtained every thirty minutes and assayed for plasma free hemolysis generation. Conclusions: The results from this initial experiment showed low plasma free hemoglobin generation and encourages the authors to further develop this concept.

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Preclinical evaluation of the Kyocera Gyro centrifugal blood pump for cardiopulmonary bypass

Perfusion ◽

10.1177/026765919701200509 ◽

1997 ◽

Vol 12 (5) ◽

pp. 335-341 ◽

Cited By ~ 6

Author(s):

Yoshiyuki Takami ◽

Yasuhisa Ohara ◽

Goro Otsuka ◽

Tadashi Nakazawa ◽

Yukihiko Nosé

Keyword(s):

Cardiopulmonary Bypass ◽

Blood Pump ◽

Centrifugal Blood Pump ◽

Preclinical Evaluation

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Performance of Lactate and CO2-Derived Parameters in Predicting Major Postoperative Complications After Cardiac Surgery With Cardiopulmonary Bypass: Protocol of a Diagnostic Accuracy Study

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.724713 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiao-Fen Zhou ◽

Rong-Guo Yu ◽

Qian Chen ◽

Yi-Min Xue ◽

Han Chen

Keyword(s):

Cardiac Surgery ◽

Cardiopulmonary Bypass ◽

Postoperative Complications ◽

Diagnostic Accuracy ◽

Partial Pressure ◽

Low Flow ◽

Diagnostic Accuracy Study ◽

Operating Characteristics ◽

Content Ratio ◽

Accuracy Study

Background: CO2-derived parameters are increasingly used to identify either low-flow status or anaerobic metabolism in shock resuscitation. However, the performance of CO2-derived parameters in cardiac surgical patients is poorly understood. This study aims to compare the performance of lactate and CO2-derived parameters in predicting major postoperative complications after cardiac surgery with cardiopulmonary bypass.Methods: This is a prospective, single-center, diagnostic accuracy study. All patients who receive elective cardiac surgery involving cardiopulmonary bypass will be screened for study eligibility. Blood samples will be taken for the calculation of CO2-derived parameters, including the venous-arterial difference in CO2 partial pressure (PCO2 gap), venous-arterial difference in CO2 content to arterial-venous O2 content ratio (Cv-aCO2/Ca-vO2), and venous-arterial difference in CO2 partial pressure to arterial-venous O2 content ratio (Pv-aCO2/Ca-vO2) at ICU admission, and 3, 6, and 12 h later. Baseline, perioperative data will be collected daily for 7 days; patients will be followed up for 28 days to collect outcome data. The primary endpoint is the occurrence of major postoperative complications. Receiver-operating characteristics (ROC) curve analysis will be carried out to assess the predictive performance of lactate and CO2-derived parameters. The performance of the ROC curves will be compared.Discussion: The performance of lactate and CO2-derived parameters in predicting major postoperative complications will be investigated in the non-sepsis population, which has not been extensively investigated. Our study will compare the two surrogates of respiratory quotient directly, which is an important strength.Trial Registration: ChiCTR, ChiCTR2000029365. Registered January 26th, 2020, http://www.chictr.org.cn/showproj.aspx?proj=48744.

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