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Cardiothoracic and Vascular Anesthesia
Anesthesia and Pain Medicine 2006;1(2):92-95.
Published online October 30, 2006.
Life Support Systems in Terms of Energy
Choon Hak Lim, Hye Won Lee, Kyung Sun, Ho Sung Son, Jung Joo Lee, Hae Ja Lim, Suk Min Yoon, Seong Ho Chang
1Department of Anesthesiology and Pain Medicine, Korea University College of Medicine, Seoul, Korea.
2Department of Cardiothoracic Surgery, Korea University College of Medicine, Seoul, Korea.
3Korea Artificial Organ Center, Korea University College of Medicine, Seoul, Korea.
The pro's and con's of pulsatile versus nonpulsatile perfusion during acute and chronic mechanical circulatory support is a longstanding controversial issue, some investigators have suggested that the simplest explanation for this controversy is a failure to quantitate adequately the pulsatile components of flow in studies. The aim of this study was to examine the pulsatility generated by centrifugal pump (CP) and a pulsatile extracorporeal life support (twin pulse life support, T-PLS) in terms of energy equivalent pressure (EEP) and surplus hemodynamic energy (SHE). METHODS: In each of the 5 cardiac arrested pigs, the outflow cannula of the CP or T-PLS was inserted into the ascending aorta, and the inflow cannula of the CP or T-PLS was placed in the right atrium. Extracorporeal circulation was maintained for 30 minutes using a pump flow of 75 ml/kg/min by CP or T-PLS, respectively. Pressure and flow were measured in the right internal carotid artery. RESULTS: No statistical difference was observed between CP and T-PLS in terms of mean carotid artery pressure. However, pulse pressure, the percent change from mean arterial pressure to EEP, and SHE in T-PLS were higher than CP (pulse pressure: 36.1 +/- 3.6 mmHg vs 9.1 +/- 1.3 mmHg, P < 0.05, the percent change from mean arterial pressure to EEP: 19.8 +/- 6.2% vs 0.2 +/- 0.3%, P < 0.05). CONCLUSIONS: In a cardiac arrested animal model, CP revealed nonpulsatility and pulsatility generated by T-PLS was effective in terms of EEP and SHE.
Key Words: centrifugal pump, energy equivalent pressure, pulsatility
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