Why the study?
Do different pediatric heart-lung machines produce varying levels of Surplus Hemodynamic Energy (SHE) in a neonatal CPB model?
Do different pediatric heart-lung machines produce varying levels of Surplus Hemodynamic Energy (SHE) in a neonatal CPB model?
The Physiologic-Pulsatile-Pump generates the greatest surplus hemodynamic energy compared to other pediatric heart-lung machines in a neonatal CPB model.
No immediate change to neonatal CPB pump selection; leaves open whether higher surplus hemodynamic energy improves clinical outcomes.
The objective of this study was to precisely quantify and compare pressure-flow waveforms in terms of Surplus Hemodynamic Energy (SHE) levels of six different pediatric heart-lung machines. Thirty-nine piglets were subjected to CPB and deep hypothermic circulatory arrest with a hydraulically-driven physiologic-pulsatile-pump, Jostra pulsatile-roller-pump, SIII pulsatile-roller-pump, SIII mast-mounted pulsatile-roller-pump with a miniature-roller-head, SIII mast-mounted non-pulsatile-roller-pump, or Stockert-CAPS-non-pulsatile-roller-pump. The SHE (ergs/cm3) = 1,332 [((∫ fpdt) / (∫ fdt)) – MAP] was calculated. Conclusions: The Physiologic-Pulsatile-Pump produced the greatest surplus hemodynamic energy. None of the non-pulsatile roller pumps generated adequate surplus hemodynamic energy. The SHE formula is a novel method to precisely quantify different levels of pulsatility and non-pulsatility for direct and meaningful comparisons.Table
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Eichstaedt et al. (2005) studied this question.
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