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Response of Rotary Blood Pumps to Changes in Preload and Afterload at a Fixed Speed Setting Are Unphysiological When Compared With the Natural Heart

机译:与自然心脏相比,旋转血泵对固定速度设置下的预紧和后紧变化的响应是不生理的

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摘要

Responses of four rotary blood pumps (Incor, Heartmate II, Heartware, and Duraheart) at a single speed setting to changes in preload and afterload were assessed using the human left ventricle as a benchmark for comparison. Data for the rotary pumps were derived from pressure flow relations reported in the literature while the natural heart was characterized by the Frank–Starling curve adjusted to fit outputs at different afterloads reported in the literature. Preload sensitivity (mean?±?SD) for all pumps at all afterloads tested was 0.105?±?0.092?L/min/mm?Hg, while afterload sensitivity was 0.09?±?0.034?L/min/mm?Hg—values that were not significantly different (t-test, P?=?0.56). By contrast, preload sensitivity of the natural heart was over twice as high (0.213?±?0.03?L/min/mm?Hg) and afterload sensitivity about one-third (0.03?±?0.01?L/min/mm?Hg) the values recorded for rotary pumps (t-test, P?
机译:以人的左心室为基准,评估了四个旋转血泵(Incor,Heartmate II,Heartware和Duraheart)在单速设置下对前负荷和后负荷变化的响应。旋转泵的数据来自文献报道的压力流量关系,而自然心脏的特征是通过Frank-Starling曲线进行调整的,以适应文献报道的不同后负荷下的输出。在所有测试的后负荷下,所有泵的预负荷灵敏度(平均值±±SD)为0.105±±0.092?L / min / mm?Hg,而后负荷敏感度为0.09±±0.034?L / min / mm?Hg-差异无显着性(t检验,P≥0.56)。相比之下,自然心脏的预负荷灵敏度高两倍(0.213Ω±?0.03ΩL/ min / mm?Hg),后负荷灵敏度约三分之一(0.03Ω±0.010.01L / min / mm?Hg) )记录的旋转泵的值(t-检验,P≤0.001)。最大的前负荷敏感性和最小的后负荷敏感性使左右心室无需神经或体液干预即可同步输出。这项理论研究强调了提供具有足够动力的预负荷敏感控制机制的需求,以使泵和左心室结合起来自动适应右心室输出的变化。

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