Effects of the pulsatile flow settings on pulsatile waveforms and hemodynamic energy in a PediVAS centrifugal pump

The objective of this study was to test different pulsatile flow settings of the PediVAS centrifugal pump to seek an optimum setting for pulsatile flow to achieve better pulsatile energy and minimal backflow. The PediVAS centrifugal pump and the conventional pediatric clinical circuit, including a pediatric membrane oxygenator, arterial filter, arterial cannula, and 1/4 in circuit tubing were used. The circuit was primed with 40% glycerin water mixture. Postcannula pressure was maintained at 40 mm Hg by a Hoffman clamp. The experiment was conducted at 800 ml/min of pump flow with a modified pulsatile flow setting at room temperature. Pump flow and pressure readings at preoxygenator and precannula sites were simultaneously recorded by a data acquisition system. The results showed that backflows appeared at flow rates of 200-800 ml/min (200 ml/min increments) with the default pulsatile flow setting and only at 200 ml/min with the modified pulsatile flow setting. With an increased rotational speed difference ratio and a decreased pulsatile width, the pulsatility increased in terms of surplus hemodynamic energy and total hemodynamic energy at preoxygenator and precannula sites. Backflows seemed at preoxygenator and precannula sites at a 70% of rotational speed difference ratio. The modified pulsatile flow setting was better than the default pulsatile flow setting in respect to pulsatile energy and backflow. The pulsatile width and the rotational speed difference ratio significantly affected pulsatility. The parameter of the rotational speed difference ratio can automatically increase pulsatility with increased rotational speeds. Further studies will be conducted to optimize the pulsatile flow setting of the centrifugal pump.