闭环自动控制系统的extracorporeal膜氧化和左心室辅助装置支持在心脏性冲击的支持
Takashi Unoki1,2, Kazunori Uemura2,3, Shohei Yokota2
1From the Department of Intensive Care Unit, Saiseikai Kumamoto Hospital, Kumamoto, Japan.
概括
一个新的自动化系统优化了静脉外体膜氧化 (VA-ECMO) 和左心室辅助装置 (LVAD) 对心脏性休克患者的支持. 这种闭环系统管理设备流和药物,以稳定血液动力学.
科学领域:
- 心血管生理学心血管生理学
- 生物医学工程 生物医学工程
- 关键护理医学 关键护理医学
背景情况:
- 静脉外体膜氧化 (VA-ECMO) 对于心脏性休克 (CS) 至关重要,但可以加剧左心室后负荷和肺.
- 穿皮左心室辅助装置 (LVAD) 可以减轻这些问题,当与VA-ECMO结合.
- 同时管理VA-ECMO和LVAD是复杂的,需要大量的资源.
研究的目的:
- 开发和评估一个闭环自动化控制系统,以支持VA-ECMO和LVAD.
- 为了保持目标血液动力学参数,包括动脉压,左心房压力和全身流量.
- 为了减少管理双重机械循环支持装置的复杂性和劳动强度.
主要方法:
- 开发了一个基于循环平衡框架的闭环自动控制系统.
- 该系统自动调整VA-ECMO和LVAD流量,心血管药物和液体剂量.
- 在七只经过麻醉的狗中监测血液动力学参数,这些狗经历了诱导心脏发生的冲击.
主要成果:
- 单独使用VA-ECMO可显著增加动脉压和左心房压力.
- 自动化系统在激活后立即降低左心房压力.
- 在激活后的60分钟内,该系统成功控制了动脉压,左心房压和目标范围内的总系统流量,同时优化了设备流量和药物剂量.
结论:
- 开发的闭环自动控制系统有效地优化了VA-ECMO和LVAD支持的血液动力学.
- 该系统为管理心脏性休克患者提供了一个有前途的工具,需要复杂的机械循环支持.
- 自动化可以简化VA-ECMO和LVAD的双重管理,从而有可能改善患者的治疗结果.
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