A clinical monitoring system for centrifugal blood pumps.
In clinical application of rotary blood pumps, flow obstruction as a result of suction of the inflow cannula, kinking of tubing, or thrombus formation occurs quite frequently. Early detection of such problems is essential to avoid hemolysis, tissue degradation, or release of thrombi to the patient. A program was developed for automatic observation of pump performance, tubing resistance, and suction effects, which requires only the measurement of already available parameters (i.e., pump speed, pump flow, aortic pressure). The software is based on Visual-C and provides a user surface formatted in Windows. Pump flow, its time derivate, and the relationship between the pulsatile component and the mean graft flow are observed to detect suction in the left atrium. Furthermore, the generated pressure head is predicted from pump speed, graft flow, and the resistance of tubing/cannula and compared with the actually measured aortic pressure. An alarm sounds if a given limit between prediction and measurement is exceeded. In a mock circulation, suction events were detected in more than 95% with a mean deviation of actual aortic pressure from its predicted value of less than 5%. For in vivo application, even incomplete suction could be detected reliably in more than 90% of events. This system improves and standardizes monitoring of pump performance; it should therefore lead to greater safety during application of such devices.
Holzer
S
S
Department of Cardiothoracic Surgery, University of Vienna, Austria.
Scherer
R
R
Schmidt
C
C
Schwendenwein
I
I
Wieselthaler
G
G
Noisser
R
R
Schima
H
H
D000465:Algorithms; D000818:Animals; D016275:Atrial Function; D001794:Blood Pressure / Q000502:physiology; D002417:Cattle; D006325:Heart Atria / Q000473:pathology; D006353:Heart-Assist Devices / Q000592:standards*; D006461:Hemolysis / Q000502:physiology; D008962:Models, Theoretical; D008991:Monitoring, Physiologic; D011673:Pulsatile Flow; D012399:Rotation; D012984:Software; D013927:Thrombosis / Q000517:prevention & control