Effects of an Extra-corporeal Life Support System Using a Dual Pulsatile Pump

Baek,  Kwang Je; Kim,  Jun Sig; Sun,  Kyung; Son,  Ho Sung; Ki,  Woong; Han,  Seung Baik; Min,  Byung Goo

J Korean Soc Emerg Med > Volume 13(4); 2002 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2002;13(4): 489-496.

Effects of an Extra-corporeal Life Support System Using a Dual Pulsatile Pump

Kwang Je Baek, Jun Sig Kim, Kyung Sun, Ho Sung Son, Woong Ki, Seung Baik Han, Byung Goo Min

¹Department of Emergency Medicine, College of Medicine, Inha University, Incheon, Korea.
²Department of Thoracic and Cardiovascular Surgery, College of Medicine, Korea University, Korea. ksunmd@kumc.or.kr
³Department of Biomedical Engineering, College of Medicine, Seoul National University, Seoul, Korea.

ABSTRACT

PURPOSE:
The purpose of this study was to observe and compare the changes in the patterns of hemodynamic and blood profiles on the circuit of Extra-corporeal life support system (ECLS) by using a dual pulsatile pump (T-PLS).
METHODS:
An acute heart failure model using partial pulmonary artery banding was constructed in 12 piglets (20 -25kg). The animals were divided into centrifugal (n=6) and dual pulsatile pump (n=6) group. Each animal was placed on an ECLS system with a membrane oxygenator bypassing the right atrium and the aorta for 2 hours under general anesthesia. The parameters mainly observed were intra-circuit pressure changes, arterial pulsatility (pulse pressure), plasma free hemoglobin, hemodynamic changes, and other blood profiles. The parameters obtained just prior to the bypass were compared with the corresponding parameters obtained two hours after the bypass.
RESULTS:
Before bypass, the parameters were statistically the same between the groups. Two hours after the bypass, no significant differences were observed between the groups in ABGA, VBGA, AST/ALT, BUN/Cr, and electrolytes; the plasma free hemoglobin was 14.8+/-4.7 g/dl in the dual pulsatile group and 19.1+/-9.1 g/dl in the centrifugal group (p=NS). The pulse pressure was higher in the dual pulsatile pump than in the centrifugal pump group (35+/-8 vs. 11+/-7 mmHg, p=0.0253 mmHg). The highest circuit pressure was generated at the inlet of the membrane oxygenator and was higher in the dual pulsatile group than in the centrifugal group (173+/-12 mmHg vs. 222+/-8 mmHg, p=0.0000).
CONCLUSION:
The results demonstrate that a dual pulsating mechanism lessens blood cell trauma while providing physiologic pulsatile blood flow. The ECLS system using a dual pulsatile pump (T-PLS) can be useed as an effective and safe driving motor for an ECLS.

Key words: CPR, Pump, Hemoglobin