A hemodynamic evaluation of the Medos Deltastream DP1 rotary pump and Jostra HL-20 roller pump under pulsatile and nonpulsatile perfusion in an infant cardiopulmonary bypass model--a pilot study.

摘要

This study aims to compare the Jostra HL-20 roller pump to the Medos DeltaStream DP1 rotary pump in terms of pressure and flow waveforms, as well as calculated energies based on pressure/flow relationships, in a simulated pediatric cardiopulmonary perfusion system. The flow rate was set at 1,000 ml/min for each pump, under both pulsatile and nonpulsatile perfusion modes. Mean arterial pressure (MAP) was maintained at 40 mm Hg. Pressure and flow measurements and waveforms were recorded at precannula site in the bypass circuit. Blood analog test fluid was used to simulate blood properties. A total of 24 experiments were performed (n = 12 nonpulsatile and n = 12 pulsatile). A significant increase in surplus hemodynamic energy (SHE) was observed in both pumps under pulsatile perfusion. In contrast, nonpulsatile perfusion generated very little SHE in the Jostra roller pump, whereas no SHE was generated in the Medos rotary pump. However, under pulsatile perfusion, the Medos rotary pump generated more than twice the amount of SHE or "extra" energy than the Jostra roller pump. The total hemodynamic energy was also significantly higher in the Medos rotary pump than the Jostra roller pump, under pulsatile perfusion. This pilot study suggests that the Medos DeltaStream DP1 rotary pump may produce greater hemodynamic energy levels and higher quality physiologic pressure/flow waveforms than the Jostra roller pump. Further investigation of the Medos DeltaStream DP1 rotary pump is necessary to evaluate hemodynamic energy generation under various pump settings, in contrast to different flow rates.