目的通过自制轴流血泵进行体外、体内溶血实验,探讨血泵的溶血特性。方法轴流血泵置于充满新鲜羊血的模拟循环通路中,在输出流量为5L/min,后负荷压力为100mmHg的条件下,检测血泵体外溶血水平。在3只健康绵羊体内植入血泵进行在体辅助实...目的通过自制轴流血泵进行体外、体内溶血实验,探讨血泵的溶血特性。方法轴流血泵置于充满新鲜羊血的模拟循环通路中,在输出流量为5L/min,后负荷压力为100mmHg的条件下,检测血泵体外溶血水平。在3只健康绵羊体内植入血泵进行在体辅助实验,并稳定运转24h,测定其在体溶血水平。结果可植入微型轴流血泵的体外溶血指数(normal index of haematolysis,NIH)为(0.01644±0.00018)g/100L。在体实验中,血泵运行无机械故障,循环辅助后血浆游离血红蛋白(plasma free hemoglobin,FHb)及乳酸脱氢酶(lactate dehydrogenase,LDH)呈现上升趋势,平均最大值分别达(79.3±7.1)g/100L、(622.3±22.5)U/L。结论血泵溶血性能在可接受范围内,接近于部分国外三代血泵溶血水平,初步具备进入动物辅助实验研究水平。展开更多
Context: Advanced heart failure (AHF) poses a global challenge, where heart transplantation is a treatment option but limited by donor scarcity. Proposal: This study aims to enhance the performance of ventricular assi...Context: Advanced heart failure (AHF) poses a global challenge, where heart transplantation is a treatment option but limited by donor scarcity. Proposal: This study aims to enhance the performance of ventricular assist devices (VADs) in the face of adverse events (AEs) using a resilience-based approach. The objective is to develop a method for integrating resilience attributes into VAD control systems, employing dynamic risk analysis and control strategies. Results: The outcomes include a resilient control architecture enabling anticipatory, regenerative, and degenerative actions in response to AEs. A method of applied resilience (MAR) based on dynamic risk management and resilience attribute analysis was proposed. Conclusion: Dynamic integration between medical and technical teams allows continuous adaptation of control systems to meet patient needs over time, improving reliability, safety, and effectiveness of VADs, with potential positive impact on the health of heart failure patients.展开更多
In principle, the heart tube of a zebrafish embryo is an impedance pump that drives blood flow forward by compressing the tube periodically and asymmetrically.In this article, we proposed a hypothesis that the blood p...In principle, the heart tube of a zebrafish embryo is an impedance pump that drives blood flow forward by compressing the tube periodically and asymmetrically.In this article, we proposed a hypothesis that the blood pumping mechanism of the zebrafish embryo heart tube can be applied to the design of pulsatile ventricular assist devices, which may overcome the shortcomings of current ventricular assist devices such as hemolysis caused by the mechanical injure of blood.展开更多
Background Mechanical ventricular assistance is an important therapeutic method for severe heart failure patients. A variety of ventricular assist devices have been designed for use, The purpose of this report was to ...Background Mechanical ventricular assistance is an important therapeutic method for severe heart failure patients. A variety of ventricular assist devices have been designed for use, The purpose of this report was to describe the experience of using Abiomed BVS5000 as a means of left ventricular support as a clinical treatment for heart failure patients. Methods From February 2004 to April 2006, 12 male patients were supported with Abiomed BVS5000 left ventricular assist device （LVAD） at Fu Wai Hospital. The average age was （55.2±9.6） years （range 39 to 68 years）. The mean body surface area was （1.76±0.1） m^2 （range 1.6 to 1.9 m^2 ）. Devices were inserted for post-cardiotomy shock after coronary artery bypass graft in 11 patients （92%） and in 1 dilated cardiomyopathy patient for acute cardiogenic shock. Modified cannulation methods by inserting the arterial cannulae in femoral artery and inserting the venous cannula in left atrium through a segment of bovine jugular vein were used in 7 patients. In this way, the device could be taken off without re-sternotomy when support was finished. A comparison was made between the modified method and routine left atrium-to-ascending aorta cannulating method. Results The median duration of support was 5 （3-43） days, with support flow rate of 3.8-4.5 L/min. There were 9 （75%） patients weaned from support and 8 （67%） patients discharged from the hospital. Four （33%） patients were dead. The most common morbidity was adverse neurological events. There is no statistical difference between modified and routine method on average in BVS5000 support duration, in assisted flow rate, in mechanical ventilation duration, in the intensive care unit stay and thoracic drainage. Conclusions The Abiomed BVS5000 is valuable to support patients with acute cardiogenic shock for short-term use. By the modified cannulating method, the weaning procedure can be effectively simplified. Optimization of inserting indication remains challenging and attributes to 展开更多
文摘目的通过自制轴流血泵进行体外、体内溶血实验,探讨血泵的溶血特性。方法轴流血泵置于充满新鲜羊血的模拟循环通路中,在输出流量为5L/min,后负荷压力为100mmHg的条件下,检测血泵体外溶血水平。在3只健康绵羊体内植入血泵进行在体辅助实验,并稳定运转24h,测定其在体溶血水平。结果可植入微型轴流血泵的体外溶血指数(normal index of haematolysis,NIH)为(0.01644±0.00018)g/100L。在体实验中,血泵运行无机械故障,循环辅助后血浆游离血红蛋白(plasma free hemoglobin,FHb)及乳酸脱氢酶(lactate dehydrogenase,LDH)呈现上升趋势,平均最大值分别达(79.3±7.1)g/100L、(622.3±22.5)U/L。结论血泵溶血性能在可接受范围内,接近于部分国外三代血泵溶血水平,初步具备进入动物辅助实验研究水平。
文摘Context: Advanced heart failure (AHF) poses a global challenge, where heart transplantation is a treatment option but limited by donor scarcity. Proposal: This study aims to enhance the performance of ventricular assist devices (VADs) in the face of adverse events (AEs) using a resilience-based approach. The objective is to develop a method for integrating resilience attributes into VAD control systems, employing dynamic risk analysis and control strategies. Results: The outcomes include a resilient control architecture enabling anticipatory, regenerative, and degenerative actions in response to AEs. A method of applied resilience (MAR) based on dynamic risk management and resilience attribute analysis was proposed. Conclusion: Dynamic integration between medical and technical teams allows continuous adaptation of control systems to meet patient needs over time, improving reliability, safety, and effectiveness of VADs, with potential positive impact on the health of heart failure patients.
基金The National Natural Science Research Foundation of Chinagrant number:31170904,11102014
文摘In principle, the heart tube of a zebrafish embryo is an impedance pump that drives blood flow forward by compressing the tube periodically and asymmetrically.In this article, we proposed a hypothesis that the blood pumping mechanism of the zebrafish embryo heart tube can be applied to the design of pulsatile ventricular assist devices, which may overcome the shortcomings of current ventricular assist devices such as hemolysis caused by the mechanical injure of blood.
文摘Background Mechanical ventricular assistance is an important therapeutic method for severe heart failure patients. A variety of ventricular assist devices have been designed for use, The purpose of this report was to describe the experience of using Abiomed BVS5000 as a means of left ventricular support as a clinical treatment for heart failure patients. Methods From February 2004 to April 2006, 12 male patients were supported with Abiomed BVS5000 left ventricular assist device （LVAD） at Fu Wai Hospital. The average age was （55.2±9.6） years （range 39 to 68 years）. The mean body surface area was （1.76±0.1） m^2 （range 1.6 to 1.9 m^2 ）. Devices were inserted for post-cardiotomy shock after coronary artery bypass graft in 11 patients （92%） and in 1 dilated cardiomyopathy patient for acute cardiogenic shock. Modified cannulation methods by inserting the arterial cannulae in femoral artery and inserting the venous cannula in left atrium through a segment of bovine jugular vein were used in 7 patients. In this way, the device could be taken off without re-sternotomy when support was finished. A comparison was made between the modified method and routine left atrium-to-ascending aorta cannulating method. Results The median duration of support was 5 （3-43） days, with support flow rate of 3.8-4.5 L/min. There were 9 （75%） patients weaned from support and 8 （67%） patients discharged from the hospital. Four （33%） patients were dead. The most common morbidity was adverse neurological events. There is no statistical difference between modified and routine method on average in BVS5000 support duration, in assisted flow rate, in mechanical ventilation duration, in the intensive care unit stay and thoracic drainage. Conclusions The Abiomed BVS5000 is valuable to support patients with acute cardiogenic shock for short-term use. By the modified cannulating method, the weaning procedure can be effectively simplified. Optimization of inserting indication remains challenging and attributes to
