No abstract

No abstract

Extracorporeal life support (ECLS) systems have been increasingly applied to groups of patients with cardiorespiratory failure, including pediatric and adult patients with respiratory failure. Current pulsatile ECLS systems use a single pulsatile blood pump that generates a high inlet pressure in the membrane oxygenator. To minimize this high inlet pressure, we have developed a new and improved ECLS system, twin pulse life support (T-PLS). To analyze the advantages of T-PLS, we have compared T-PLS with a single pulsatile ECLS system. An acute heart failure model was constructed by using a pulmonary artery banding technique. Fourteen pigs (22-31 kg) were used, with cardiac outputs of 2.0 l/min and a V/Q ratio set at 1. Cannulae of 28 Fr and 18 Fr were used in the right atrium and aorta, respectively. A polypropylene hollow-fiber membrane oxygenator and four polymer valves 30 mm in diameter were used in the T-PLS system. In the single pulsatile ECLS system, Medtronic Hall monostrut valves were used. To evaluate blood cell trauma in both pulsatile ECLS systems, plasma free hemoglobin (fHb) was measured while the systems were in use. The results show that fHb levels in T-PLS are lower than fHb levels in the single pulsatile ECLS system. There is a possibility that T-PLS could be used as an ECLS system for emergency situations.

A Korean artificial heart (AnyHeart) has been implanted in 29 various animals (52-470 kg) to evaluate hemodynamic performance and electromechanical stability. Most were implantable biventricular assist devices in use. A right thoracotomy approach has been a standard technique of implantation. A preclinical fitting test was also performed to observe anatomical feasibility and to compare surgical techniques in 10 human cadavers. The first case of human application was made as a lifesaving procedure on June 12, 2001.

Heparin anticoagulation is utilized during and after vascular surgery in animals to reduce the risk of acute or chronic thromboembolic problems. In this study, we examined variation of activated partial thromboplastin time APTT) after the intravenous bolus IV bolus) and subcutaneous SC) heparin injection in order to monitor heparin therapy in sheep. Nine healthy sheep were assigned to 3 groups A, B, and C) according to their body weights: less than 40 kg, 40 to 80 kg, and more than 80 kg, respectively. All animals were treated with heparin 300 IU/kg body weight) through two routes, and the APTT, fibrinogen, and platelet count were measured before and every hour after treatment. This showed that the APTT was increased significantly between 1 to 4 hours after IV bolus injection and between 2 to 6 hours after SC injection P < 0.05). The APTT was returned to baseline values 6 and 10 hours after the respective treatments. The APTT in Group C was consistently higher than in Group A and B after heparin treatment by the two routes. The APTT ratio entered the subtherapeutic range 5 and 8 hours after IV bolus and SC injection, respectively. The APTT ratio was maintained in the therapeutic range for about 1 and 4 hours after IV bolus and SC injection, respectively. The highest APTT ratio in Group C after SC injection of heparin was significantly higher than that in Groups A and B P < 0.05). The mean platelet counts in Groups A, B, and C before the injection were 3197 +/- 365.6, 2886 +/- 78.2, and 1861 +/- 298.0 102/microL, respectively. The mean platelet count gradually decreased without significant variation after IV bolus and SC injection. These results produced elementary data for monitoring in sheep using APTT, and suggested that heparin should be administrated by the SC route at 4-hour intervals in order to remain in the therapeutic range, after an initial IV bolus dose.