title: Reserve-driven flow control for extracorporeal life support: proof of principle.
abstract: Extracorporeal life support systems lack volume-buffering capacity. Therefore, any decrease in venous intravascular volume available for drainage may result in acutely reduced support flow. We recently developed a method to quantify drainable volume and now conceived a reserve-driven pump control strategy, which is different from existing pressure or flow servo control schemes. Here, we give an outline of the algorithm and present animal experimental data showing proof of principle. With an acute reduction in circulatory volume (10-15%), pump flow immediately dropped from 4.1 to 1.9 l/min. Our pump control algorithm was able to restore bypass flow to 3.2 l/min (about 80% of the original level) and, thereby, reduced the duration of the low-flow condition. This demonstrates that a reserve-driven pump control strategy, based on the continuous monitoring of drainable volume, may maintain extracorporeal circulatory support flow, despite serious changes in filling conditions.
authors.affiliation: Dept. of Cardiothoracic Surgery, Cardiovascular Research Institute Maastricht - CARIM, Maastricht University Medical Centre - MUMC, Maastricht, the Netherlands. antoinepsimons@ctc.unimaas.nl
authors.forename: A P
authors.initials: AP
authors.lastname: Simons
authors.forename: K D
authors.initials: KD
authors.lastname: Reesink
authors.forename: M D
authors.initials: MD
authors.lastname: Lancé
authors.forename: T
authors.initials: T
authors.lastname: van der Nagel
authors.forename: F H
authors.initials: FH
authors.lastname: van der Veen
authors.forename: P W
authors.initials: PW
authors.lastname: Weerwind
authors.forename: J G
authors.initials: JG
authors.lastname: Maessen
mesh_terms: D000465:Algorithms; D000818:Animals; D001810:Blood Volume; D002315:Cardiopulmonary Bypass / Q000295:instrumentation / Q000379:methods; D003201:Computers; D004867:Equipment Design; D005112:Extracorporeal Circulation / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006041:Goats; D006439:Hemodynamics; D007260:Infusion Pumps; D008020:Life Support Care / Q000295:instrumentation* / Q000379:methods*; D023421:Models, Animal; D012984:Software