Monitoring of Diaphragm Position in Pulsatile Pnumatic Ventricular Assisted Device by Ultrasound Sensor (A New Method for Flow Measurement in VAD)

摘要

A new method using ultrasound sensors to detect the diaphragm position of a "ventricular assist device (VAD) was proposed. Two small ultrasound sensors of 2.4 mm diameter were attached to the outside surface of blood chamber of a pneumatic VAD. The receiving crystal received the ultrasound from the transmitting crystal reflected by the diaphragm. The diaphragm position was calculated by using geometric relation among two sensors and ultrasound propagation time. Validity of this method was evaluated in a mock circulation test under various driving conditions of VAD by comparing the ultrasound signals with driving pressure waveforms. The ultrasound signals could detect full-fill (FF) and full-eject (FE) status shortly before the spikes appeared on pressure waves, which are currently available to detect FE and FF but accompanies excessive extension of the diaphragm. This method would be helpful to avoid overloading of diaphragm. Linear correlation was observed between the output from VAD and blood volume calculated from the change of diaphragm position multiplied by the heart rate. This monitoring method of diaphragm of a VAD was proven to have advantages over the current method toward better control of a pneumatic VAD.