title: Use of a pulsatile ventricular assist device (Berlin Heart EXCOR) and an interventional lung assist device (Novalung) in an animal model.
abstract: Pulsatile ventricular assist devices (VADs) are used in pediatric patients mainly as a bridge to heart transplantation. If severe respiratory failure occurs, extracorporeal membrane oxygenation (ECMO) is currently the treatment of choice. ECMO has the potential for severe complications. Interventional lung assist (iLA) devices, e.g., the Novalung, are used in patients with isolated lung failure. This study aimed to show the feasibility of the combined use of the EXCOR VAD (10 ml and 30 ml blood pumps) and the Novalung. There were two separate experiments within this study. First, a bench test was carried out to analyze pressure and flow through both devices. Second, 10 kg and 30 kg pigs received support with the VAD and iLA in series. Pressures and flow were measured systemically before and after the iLA. Flow was unaffected by the iLA. The mean arterial pressure was reduced (mean of 13 mm Hg) by the iLA. There were no obvious difficulties observed within the interaction of VAD and iLA. The combined use of both devices is feasible and able to provide sufficient perfusion pressures. Oxygenation and CO2 clearance was effectively supported by the iLA. Patients with myocardial and respiratory failure may benefit from this setup.
authors.affiliation: Department of Anaesthesia, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Julius Z
authors.initials: JZ
authors.lastname: Wermelt
authors.forename: Osami
authors.initials: O
authors.lastname: Honjo
authors.forename: Ali
authors.initials: A
authors.lastname: Kilic
authors.forename: Glen
authors.initials: G
authors.lastname: van Arsdell
authors.forename: Colleen
authors.initials: C
authors.lastname: Gruenwald
authors.forename: Tilman
authors.initials: T
authors.lastname: Humpl
mesh_terms: D000818:Animals; D001792:Blood Platelets / Q000166:cytology; D001794:Blood Pressure; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000662:veterinary*; D005240:Feasibility Studies; D006353:Heart-Assist Devices / Q000662:veterinary*; D006454:Hemoglobins / Q000032:analysis; D023421:Models, Animal; D010976:Platelet Count; D011474:Prosthesis Design / Q000295:instrumentation / Q000662:veterinary*; D011673:Pulsatile Flow; D013552:Swine
chemical_list: D006454:Hemoglobins