Quantification of perfusion modes in terms of surplus hemodynamic energy levels in a simulated pediatric CPB model

Akif Undar, Bingyang Ji, Branka Lukic, Conrad M. Zapanta, Allen Kunselman, John D. Reibson, William Weiss, Gerson Rosenberg, John Myers

Research output: Contribution to journalArticle

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Abstract

The objective of this investigation was to compare pulsatile versus nonpulsatile perfusion modes in terms of surplus hemodynamic energy (SHE) levels during cardiopulmonary bypass (CPB) in a simulated neonatal model.The extracorporeal circuit consisted of a Jostra HL-20 heart-lung machine (for both pulsatile and nonpulsatile modes of perfusion), a Capiox Baby RX hollow-fiber membrane oxygenator, a Capiox pediatric arterial filter, 5 feet of arterial tubing and 6 feet of venous tubing with a quarter-inch diameter. The circuit was primed with a lactated Ringers solution. The systemic resistance of a pseudo-patient (mean weight, 3 kg) was simulated by placing a clamp at the end of the arterial line. The pseudo-patient was subjected to five pump flow rates in the 400 to 800 ml/min range. During pulsatile perfusion, the pump rate was kept constant at 120 bpm. Pressure waveforms were recorded at the preoxygenator, postoxygenator, and preaortic cannula sites. SHE was calculated by use of the following formula {SHE (ergs/cm) = 1,332 [((∫ fpdt) / (∫ fdt)) - Mean Arterial Pressure]} (f = pump flow and p = pressure). A total of 60 experiments were performed (n = 6 for nonpulsatile and n = 6 for pulsatile) at each of the five flow rates. A linear mixed-effects model, which accounts for the correlation among repeated measurements, was fit to the data to assess differences in SHE between flows, pumps, and sites. The Tukey multiple comparison procedure was used to adjust p values for post hoc pairwise comparisons.With a pump flow rate of 400 ml/min, pulsatile flow generated significantly higher surplus hemodynamic energy levels at the preoxygenator site (23,421 ± 2,068 ergs/cm vs. 4,154 ± 331 ergs/cm, p < 0.0001), the postoxygenator site (18,784 ± 1,557 ergs/cm vs. 3,383 ± 317 ergs/cm, p < 0.0001), and the precannula site (6,324 ± 772 ergs/cm vs. 1,320 ± 91 ergs/cm, p < 0.0001), compared with the nonpulsatile group. Pulsatile flow produced higher SHE levels at all other pump flow rates.The Jostra HL-20 roller pump generated significantly higher SHE levels in the pulsatile mode when compared with the nonpulsatile mode at all five pump flow rates.

Original languageEnglish (US)
Pages (from-to)712-717
Number of pages6
JournalASAIO Journal
Volume52
Issue number6
DOIs
StatePublished - Nov 1 2006

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Pediatrics
Hemodynamics
Cardiopulmonary Bypass
Electron energy levels
Perfusion
Pumps
Pulsatile Flow
Flow rate
Pulsatile flow
Tubing
Heart-Lung Machine
Membrane Oxygenators
Pressure
Oxygenators
Vascular Access Devices
Networks (circuits)
Clamping devices
Arterial Pressure
Weights and Measures
Membranes

All Science Journal Classification (ASJC) codes

  • Biophysics
  • Bioengineering
  • Biomaterials
  • Biomedical Engineering

Cite this

@article{f236ca6edaf24f91bceb33ce5c57e3af,
title = "Quantification of perfusion modes in terms of surplus hemodynamic energy levels in a simulated pediatric CPB model",
abstract = "The objective of this investigation was to compare pulsatile versus nonpulsatile perfusion modes in terms of surplus hemodynamic energy (SHE) levels during cardiopulmonary bypass (CPB) in a simulated neonatal model.The extracorporeal circuit consisted of a Jostra HL-20 heart-lung machine (for both pulsatile and nonpulsatile modes of perfusion), a Capiox Baby RX hollow-fiber membrane oxygenator, a Capiox pediatric arterial filter, 5 feet of arterial tubing and 6 feet of venous tubing with a quarter-inch diameter. The circuit was primed with a lactated Ringers solution. The systemic resistance of a pseudo-patient (mean weight, 3 kg) was simulated by placing a clamp at the end of the arterial line. The pseudo-patient was subjected to five pump flow rates in the 400 to 800 ml/min range. During pulsatile perfusion, the pump rate was kept constant at 120 bpm. Pressure waveforms were recorded at the preoxygenator, postoxygenator, and preaortic cannula sites. SHE was calculated by use of the following formula {SHE (ergs/cm) = 1,332 [((∫ fpdt) / (∫ fdt)) - Mean Arterial Pressure]} (f = pump flow and p = pressure). A total of 60 experiments were performed (n = 6 for nonpulsatile and n = 6 for pulsatile) at each of the five flow rates. A linear mixed-effects model, which accounts for the correlation among repeated measurements, was fit to the data to assess differences in SHE between flows, pumps, and sites. The Tukey multiple comparison procedure was used to adjust p values for post hoc pairwise comparisons.With a pump flow rate of 400 ml/min, pulsatile flow generated significantly higher surplus hemodynamic energy levels at the preoxygenator site (23,421 ± 2,068 ergs/cm vs. 4,154 ± 331 ergs/cm, p < 0.0001), the postoxygenator site (18,784 ± 1,557 ergs/cm vs. 3,383 ± 317 ergs/cm, p < 0.0001), and the precannula site (6,324 ± 772 ergs/cm vs. 1,320 ± 91 ergs/cm, p < 0.0001), compared with the nonpulsatile group. Pulsatile flow produced higher SHE levels at all other pump flow rates.The Jostra HL-20 roller pump generated significantly higher SHE levels in the pulsatile mode when compared with the nonpulsatile mode at all five pump flow rates.",
author = "Akif Undar and Bingyang Ji and Branka Lukic and Zapanta, {Conrad M.} and Allen Kunselman and Reibson, {John D.} and William Weiss and Gerson Rosenberg and John Myers",
year = "2006",
month = "11",
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language = "English (US)",
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Quantification of perfusion modes in terms of surplus hemodynamic energy levels in a simulated pediatric CPB model. / Undar, Akif; Ji, Bingyang; Lukic, Branka; Zapanta, Conrad M.; Kunselman, Allen; Reibson, John D.; Weiss, William; Rosenberg, Gerson; Myers, John.

In: ASAIO Journal, Vol. 52, No. 6, 01.11.2006, p. 712-717.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Quantification of perfusion modes in terms of surplus hemodynamic energy levels in a simulated pediatric CPB model

AU - Undar, Akif

AU - Ji, Bingyang

AU - Lukic, Branka

AU - Zapanta, Conrad M.

AU - Kunselman, Allen

AU - Reibson, John D.

AU - Weiss, William

AU - Rosenberg, Gerson

AU - Myers, John

PY - 2006/11/1

Y1 - 2006/11/1

N2 - The objective of this investigation was to compare pulsatile versus nonpulsatile perfusion modes in terms of surplus hemodynamic energy (SHE) levels during cardiopulmonary bypass (CPB) in a simulated neonatal model.The extracorporeal circuit consisted of a Jostra HL-20 heart-lung machine (for both pulsatile and nonpulsatile modes of perfusion), a Capiox Baby RX hollow-fiber membrane oxygenator, a Capiox pediatric arterial filter, 5 feet of arterial tubing and 6 feet of venous tubing with a quarter-inch diameter. The circuit was primed with a lactated Ringers solution. The systemic resistance of a pseudo-patient (mean weight, 3 kg) was simulated by placing a clamp at the end of the arterial line. The pseudo-patient was subjected to five pump flow rates in the 400 to 800 ml/min range. During pulsatile perfusion, the pump rate was kept constant at 120 bpm. Pressure waveforms were recorded at the preoxygenator, postoxygenator, and preaortic cannula sites. SHE was calculated by use of the following formula {SHE (ergs/cm) = 1,332 [((∫ fpdt) / (∫ fdt)) - Mean Arterial Pressure]} (f = pump flow and p = pressure). A total of 60 experiments were performed (n = 6 for nonpulsatile and n = 6 for pulsatile) at each of the five flow rates. A linear mixed-effects model, which accounts for the correlation among repeated measurements, was fit to the data to assess differences in SHE between flows, pumps, and sites. The Tukey multiple comparison procedure was used to adjust p values for post hoc pairwise comparisons.With a pump flow rate of 400 ml/min, pulsatile flow generated significantly higher surplus hemodynamic energy levels at the preoxygenator site (23,421 ± 2,068 ergs/cm vs. 4,154 ± 331 ergs/cm, p < 0.0001), the postoxygenator site (18,784 ± 1,557 ergs/cm vs. 3,383 ± 317 ergs/cm, p < 0.0001), and the precannula site (6,324 ± 772 ergs/cm vs. 1,320 ± 91 ergs/cm, p < 0.0001), compared with the nonpulsatile group. Pulsatile flow produced higher SHE levels at all other pump flow rates.The Jostra HL-20 roller pump generated significantly higher SHE levels in the pulsatile mode when compared with the nonpulsatile mode at all five pump flow rates.

AB - The objective of this investigation was to compare pulsatile versus nonpulsatile perfusion modes in terms of surplus hemodynamic energy (SHE) levels during cardiopulmonary bypass (CPB) in a simulated neonatal model.The extracorporeal circuit consisted of a Jostra HL-20 heart-lung machine (for both pulsatile and nonpulsatile modes of perfusion), a Capiox Baby RX hollow-fiber membrane oxygenator, a Capiox pediatric arterial filter, 5 feet of arterial tubing and 6 feet of venous tubing with a quarter-inch diameter. The circuit was primed with a lactated Ringers solution. The systemic resistance of a pseudo-patient (mean weight, 3 kg) was simulated by placing a clamp at the end of the arterial line. The pseudo-patient was subjected to five pump flow rates in the 400 to 800 ml/min range. During pulsatile perfusion, the pump rate was kept constant at 120 bpm. Pressure waveforms were recorded at the preoxygenator, postoxygenator, and preaortic cannula sites. SHE was calculated by use of the following formula {SHE (ergs/cm) = 1,332 [((∫ fpdt) / (∫ fdt)) - Mean Arterial Pressure]} (f = pump flow and p = pressure). A total of 60 experiments were performed (n = 6 for nonpulsatile and n = 6 for pulsatile) at each of the five flow rates. A linear mixed-effects model, which accounts for the correlation among repeated measurements, was fit to the data to assess differences in SHE between flows, pumps, and sites. The Tukey multiple comparison procedure was used to adjust p values for post hoc pairwise comparisons.With a pump flow rate of 400 ml/min, pulsatile flow generated significantly higher surplus hemodynamic energy levels at the preoxygenator site (23,421 ± 2,068 ergs/cm vs. 4,154 ± 331 ergs/cm, p < 0.0001), the postoxygenator site (18,784 ± 1,557 ergs/cm vs. 3,383 ± 317 ergs/cm, p < 0.0001), and the precannula site (6,324 ± 772 ergs/cm vs. 1,320 ± 91 ergs/cm, p < 0.0001), compared with the nonpulsatile group. Pulsatile flow produced higher SHE levels at all other pump flow rates.The Jostra HL-20 roller pump generated significantly higher SHE levels in the pulsatile mode when compared with the nonpulsatile mode at all five pump flow rates.

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