title: Peripheral organ perfusion augmentation during left ventricular failure. A controlled bovine comparison between the intraaortic balloon pump and the Hemopump.
abstract: Despite the use of inotropic therapy and the intraaortic balloon pump (IABP), inadequate peripheral organ perfusion and subsequent multiorgan failure from left ventricular dysfunction is a major cause of death following cardiac surgery. To compare the end-organ perfusion provided by the IABP with that of the recently developed Hemopump Cardiac Assist System, blood flow from visceral organs was measured by ultrasonic flow probes during separate periods of support with each of these pumps. Ten calves underwent coronary artery ligations with beta-receptor blockade; hemodynamic parameters were recorded before the induction of failure, during unsupported cardiac failure, and during Hemopump and IABP support. Improvement in mean cardiac output, mixed venous oxygen saturation, and pulmonary artery wedge pressure was significantly greater (p < 0.05) during Hemopump support than during IABP support. Renal artery flow was significantly greater during Hemopump support (276 +/- 74.2 cc/min) than during IABP support (164 +/- 79.6 cc/min). Hepatic artery flow was significantly greater during Hemopump support (34.7 +/- 25.7 cc/min) than during IABP support (24.4 +/- 18.9 cc/min), and portal vein flow was significantly greater during Hemopump support (1588 +/- 315 cc/min) than IABP support (1259 +/- 310 cc/min). There were no significant differences, however, between carotid artery flow during Hemopump support (292 +/- 171 cc/min) and that during IABP support (317 +/- 204 cc/min). We conclude that renal, hepatic, and mesenteric perfusion provided by the nonpulsatile Hemopump is superior to that of the IABP in this bovine model of left ventricular failure. Therefore, the Hemopump may be more effective in preventing multiorgan failure during recovery of ventricular function.
authors.affiliation: Cullen Cardiovascular Research Laboratories, Texas Heart Institute, Houston 77225-0345.
authors.forename: R T
authors.initials: RT
authors.lastname: Baldwin
authors.forename: B
authors.initials: B
authors.lastname: Radovancević
authors.forename: J L
authors.initials: JL
authors.lastname: Conger
authors.forename: R
authors.initials: R
authors.lastname: Matsuwaka
authors.forename: J M
authors.initials: JM
authors.lastname: Duncan
authors.forename: W K
authors.initials: WK
authors.lastname: Vaughn
authors.forename: R K
authors.initials: RK
authors.lastname: Wampler
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
mesh_terms: D000818:Animals; D001775:Blood Circulation; D002303:Cardiac Output, Low / Q000503:physiopathology / Q000628:therapy*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000379:methods; D002417:Cattle; D005260:Female; D006353:Heart-Assist Devices; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology / Q000517:prevention & control; D016276:Ventricular Function