Response of Rotary Blood Pumps to Changes in Preload and Afterload at a Fixed Speed Setting Are Unphysiological When Compared With the Natural Heart

Artificial Organs - Tập 35 Số 3 - 2011
Robert F. Salamonsen1,2,3, D. G. Mason3, Peter Ayre4
1Department of Epidemiology and Preventive Medicine, Monash University
2Department of Intensive Care Alfred Hospital, Melbourne
3Department of Surgery, Monash University, Victoria
4Thorvascular Pty Ltd., Sydney, Australia

Tóm tắt

AbstractResponses of four rotary blood pumps (Incor, Heartmate II, Heartware, and Duraheart) at a single speed setting to changes in preload and afterload were assessed using the human left ventricle as a benchmark for comparison. Data for the rotary pumps were derived from pressure flow relations reported in the literature while the natural heart was characterized by the Frank–Starling curve adjusted to fit outputs at different afterloads reported in the literature. Preload sensitivity (mean ± SD) for all pumps at all afterloads tested was 0.105 ± 0.092 L/min/mm Hg, while afterload sensitivity was 0.09 ± 0.034 L/min/mm Hg—values that were not significantly different (t‐test, P = 0.56). By contrast, preload sensitivity of the natural heart was over twice as high (0.213 ± 0.03 L/min/mm Hg) and afterload sensitivity about one‐third (0.03 ± 0.01 L/min/mm Hg) the values recorded for rotary pumps (t‐test, P < 0.001). Maximum preload sensitivity and minimum afterload sensitivity allow the right and left ventricles to synchronize outputs without neural or humoral intervention. This theoretical study reinforces the need to provide preload sensitive control mechanisms of sufficient power to enable the pump and left ventricle in combination to adapt to changes in right ventricular output automatically.

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Artificial Organs

Tập 35 Số 3

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