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Effects of Pulsatile Control Algorithms for Diagonal Pump on Hemodynamic Performance and Hemolysis
Shigang Wang1, Madison Force1, Morgan K Moroi1
1Penn State Hershey Pediatric Cardiovascular Research Center, Department of Pediatrics, Penn State Milton S. Hershey Medical Center, Penn State Hershey College of Medicine, Penn State Hershey Children's Hospital, Hershey, PA, USA.
Artificial Organs
|October 31, 2018
Summary
Comparing Medos DeltaStream DP3 and i-cor pumps in extracorporeal circulation (ECLS), this study found that while higher pulsatility increases hemodynamic energy, it also elevates hemolysis risk. Optimized pulsatile control is crucial for balancing efficacy and safety in ECLS.
Area of Science:
- Cardiovascular Engineering
- Biomedical Engineering
- Hemodynamics
Background:
- Extracorporeal Circulation (ECLS) systems utilize pumps to support patients with failing cardiorespiratory function.
- Pulsatile flow in ECLS aims to mimic physiological circulation, potentially improving organ perfusion and reducing complications.
- Different pump technologies and control algorithms may significantly impact hemodynamic performance and biocompatibility.
Purpose of the Study:
- To compare the hemodynamic performance of Medos DeltaStream DP3 and i-cor diagonal pumps under various pulsatile control algorithms in simulated pediatric and adult ECLS.
- To evaluate the risk of hemolysis associated with different pulsatile settings in these ECLS pumps.
- To assess the impact of pulsatile amplitude and flow rate on hemodynamic energy delivery and pump efficiency.
Main Methods:
- Simulated pediatric and adult ECLS circuits were established using i-cor pump heads with either i-cor or Medos DeltaStream MDC consoles.
- Trials were conducted at varying flow rates (0.5-4 L/min) under nonpulsatile and pulsatile modes, with adjustable pulsatile amplitudes.
- Hemodynamic parameters (Energy Equivalent Pressure, Total Hemodynamic Energy, Surplus Hemodynamic Energy) and plasma free hemoglobin levels (indicating hemolysis) were measured.
Main Results:
- Pulsatile mode generally increased Energy Equivalent Pressure compared to mean pressure.
- Total Hemodynamic Energy and Surplus Hemodynamic Energy increased with pulsatile amplitude but decreased with higher flow rates.
- The i-cor pump was superior at low flow rates, while the Medos pump excelled at high flow rates; higher pulsatile speeds increased hemolysis risk, particularly with the Medos DP3 at 4 L/min.
Conclusions:
- Pulsatile control algorithms significantly influence hemodynamic performance and pulsatility in ECLS.
- High pulsatile amplitudes enhance hemodynamic energy delivery but concurrently increase the risk of hemolysis.
- Optimized pulsatile settings and intermittent pulsatile modes are recommended to balance hemodynamic benefits and minimize hemolysis in ECLS.
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