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1 Biocybernetics and Biomedical Engineering

1 2005

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Influence of pulsatile organ perfusion pump on organ flow kinetics in the "in vivo" model of cardiopulmonary bypass

Gu Y. J., de Kroon T. L., Elstrodt J. M., Rakhorst G.

Biocybernetics and Biomedical Engineering

2005

Vol. 25, no. 2

19-26

Pulsatile perfusion flow resembling the natural heart beat during cardiopulmonary bypass (CPB) for open-heart surgery is more physiological than the non-pulsatile flow. However, the conventional idea of generating the pulsatile flow is far from satisfactory because of the resistance of the oxygenator and aortic cannula that counteract the force of the pulsatile pumps. The pulsatile organ perfusion pump is an intra-aortic pulsatile catheter pump developed to create an effective pulsatile flow to the abdominal organs, such as the kidneys and the gastrointestinal tract, during non-pulsatile CPB. In a porcine model of CPB, 12 adult-size pigs were divided into a pulsatile group perfused with the roller pump and the organ perfusion pump during the ischemic phase of CPB (OPP, n = 6) and the non-pulsatile group perfused with the roller pump alone (Control, n = 6). All the animal experiments were standardized to have the CPB duration of 120 minutes, with the aorta cross-clamped for 60 minutes. During CPB the animals were cooled down to 32°C with an average roller pump flow of 60 ml/kg/min by the heart-lung machine. The results showed that during the ischemic phase of CPB, when the natural heart beat stopped, the organ perfusion pump produced an effective pulsation of the blood flow to the organs, as measured by the ultrasonic flow meters from the left renal artery, superior mesenteric artery, and the right carotid artery. During the similar period of time, the systolic blood pressure was significantly higher in the OPP group than in the control group. As a result, the hemodynamic energy delivered to the organs, as indicated by the energy equivalent pressure, was significantly higher in the OPP group. In the values of the average blood flow to the kidneys, the gastrointestinal tract, and the brain was largely no difference between the two groups. In conclusion, the pulsatile organ perfusion pump generates an effective pulsatility of the blood flow and the hemodynamic energy to the vital organs during the ischemic phase of CPB, when the natural heart gives no pulse.