Haemolysis in patients with ventricular assist devices: major differences between systems☆

Heilmann, Claudia; Geisen, Ulrich; Benk, Christoph; Berchtold‐Herz, Michael; Trummer, Christian; Schlensak, Christian; Zieger, Barbara; Beyersdorf, Friedhelm

doi:10.1016/j.ejcts.2009.04.015

Cited by 87 publications

(71 citation statements)

References 25 publications

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“…Blood pump design may also influence the level of hemolysis experienced with extended support. 9 The consolation for this concern, although it is not desired, is that some level of hemolysis can be tolerated. It has been reported by Gbadegesin et al 7 in a retrospective review of 104 pediatric ECMO patients that mean peak plasma free hemoglobin during ECMO and mean plasma free hemoglobin at the end of the ECMO run in the group of survivors was 48.4 and 16.8 mg/dL, where the patients that died during ECMO support had mean peak and mean average values of plasma free hemoglobin at the end of the ECMO run of 93.6 and 41.1 mg/dL.…”

Section: Discussionmentioning

confidence: 98%

In Vitro Pumping Performance Evaluation of the Ension Pediatric Cardiopulmonary Assist System for Venoarterial and Venovenous ECMO

Pantalos

Abel

Ravisankar

et al. 2012

Cardiovasc Eng Tech

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The purpose of this study is to determine the pumping performance of Revision 7 of the Ension pediatric cardiopulmonary assist system (pCAS) when used with cannulae for venoarterial (VA) or venovenous (VV) extracorporeal membrane oxygenation (ECMO). It was hypothesized that the pCAS could deliver flow rates within recommended ranges needed to provide adequate cardiopulmonary support for neonates and infants. Rev 7 pCAS pumping performance was evaluated with the pCAS incorporated into an ECMO circuit connected to an instrumented pediatric mock circulation with cannulae combinations commonly used clinically for VA ECMO or dual lumen cannulae for VV ECMO. The pCAS motor speed was operated from 0 to 4500 rpm while the pCAS pumped blood analog solutions representing a clinically relevant range of viscosity. Maximum flow rates were inversely related to viscosity and were directly proportional to cannulae size. At 4500 rpm, maximum pCAS flow for the VA ECMO configuration was 2.14 L/min for the lowest viscosity and largest cannula combination and 0.72 L/ min for the highest viscosity and the smallest cannulae combination. At a flow of 0.5 L/min, the pressure drop across the pCAS ranged from 121 to 323 mmHg depending on viscosity and cannulae combination. For the VV ECMO configuration at 4500 rpm, the maximum pCAS flow was 1.21 L/min for the lowest viscosity and largest cannula and 0.58 L/min for the highest viscosity and smallest cannula. For a flow of 0.5 L/min, the pressure drop across the pCAS ranged from 82 to 407 mmHg depending on the viscosity and cannula. Possible transition to turbulent flow (Re > 2100 at cannula inlet) was found at the higher flow rates achieved with the lower viscosity test fluid for all cannulae tested. In conclusion, across the range of pump speeds and fluid viscosities evaluated, the pCAS can generate the flow rates recommended to provide adequate cardiopulmonary support for neonates and infants with commonly used clinical cannulae combinations, thus confirming the hypotheses.

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Section: Discussionmentioning

confidence: 98%

In Vitro Pumping Performance Evaluation of the Ension Pediatric Cardiopulmonary Assist System for Venoarterial and Venovenous ECMO

Pantalos

Abel

Ravisankar

et al. 2012

Cardiovasc Eng Tech

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“…VADs were implanted according to usual surgical techniques, as previously described [1,10]. The HMII is operated at nearly 9000 rpm.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Acquired Von Willebrand syndrome is an early-onset problem in ventricular assist device patients

Heilmann

Geisen

Beyersdorf

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…The blood damage induced by blood pumps represents a complex topic, and different outcomes in this regard have been observed clinically with different types of devices [44]. Increased hemolysis due to speed modulation has been reported for a commercially available centrifugal pump in vitro [45,46].…”

Section: Constant Speed Solutionmentioning

confidence: 99%

Numerical Optimal Control of Turbo Dynamic Ventricular Assist Devices

et al. 2013

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Abstract:The current paper presents a methodology for the derivation of optimal operating strategies for turbo dynamic ventricular assist devices (tVADs). In current clinical practice, tVADs are typically operated at a constant rotational speed, resulting in a blood flow with a low pulsatility. Recent research in the field has aimed at optimizing the interaction between the tVAD and the cardiovascular system by using predefined periodic speed profiles. In the current paper, we avoid the limitation of using predefined profiles by formulating an optimal-control problem based on a mathematical model of the cardiovascular system and the tVAD. The optimal-control problem is solved numerically, leading to cycle-synchronized speed profiles, which are optimal with respect to an arbitrary objective. Here, an adjustable trade-off between the maximization of the flow through the aortic valve and the minimization of the left-ventricular stroke work is chosen. The optimal solutions perform better than constant-speed or sinusoidal-speed profiles for all cases studied. The analysis of optimized solutions provides insight into the optimized Bioengineering 2014, 1 23 interaction between the tVAD and the cardiovascular system. The numerical approach to the optimization of this interaction represents a powerful tool with applications in research related to tVAD control. Furthermore, patient-specific, optimized VAD actuation strategies can potentially be derived from this approach.

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Haemolysis in patients with ventricular assist devices: major differences between systems☆

Cited by 87 publications

References 25 publications

In Vitro Pumping Performance Evaluation of the Ension Pediatric Cardiopulmonary Assist System for Venoarterial and Venovenous ECMO

In Vitro Pumping Performance Evaluation of the Ension Pediatric Cardiopulmonary Assist System for Venoarterial and Venovenous ECMO

Acquired Von Willebrand syndrome is an early-onset problem in ventricular assist device patients

Numerical Optimal Control of Turbo Dynamic Ventricular Assist Devices

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