Abstract:
:The objective of this study was to evaluate the hemodynamic performance and gaseous microemboli (GME) handling ability of a simulated neonatal extracorporeal life support (ECLS) circuit with an in-line continuous renal replacement therapy (CRRT) device. The circuit consisted of a Maquet RotaFlow centrifugal pump or HL20 roller pump, Quadrox-iD Pediatric diffusion membrane oxygenator, 8-Fr arterial cannula, 10-Fr venous cannula, and Better-Bladder (BB) with "Y" connector. A second Quadrox-I Adult oxygenator was added postarterial cannula for GME experiments. The circuit and pseudo-patient were primed with lactated Ringer's solution and packed human red blood cells (hematocrit 40%). All hemodynamic trials were conducted at ECLS flow rates ranging from 200 to 600 mL/min and CRRT flow rate of 75 mL/min at 36°C. Real-time pressure and flow data were recorded with a data acquisition system and GME were detected and characterized using the Emboli Detection and Classification Quantifier System. CRRT was added at distinct locations such that blood entered CRRT between the pump and oxygenator (A), recirculated through the pump (B), or bypassed the pump (C). With the centrifugal pump, all CRRT positions had similar flow rates, mean arterial pressure (MAP), and total hemodynamic energy (THE) loss. With the roller pump, C demonstrated increased flow rates (293.2-686.4 mL/min) and increased MAP (59.4-75.5 mm Hg) (P < 0.01); B had decreased flow rates (129.7-529.7 mL/min), and MAP (34.2-45.0 mm Hg) (P < 0.01); A maintained the same when compared to without CRRT. At 600 mL/min C lost more THE (81.4%) (P < 0.01) with a larger pressure drop across the oxygenator (95.6 mm Hg) (P < 0.01) than without CRRT (78.3%; 49.1 mm Hg) (P < 0.01). C also demonstrated a poorer GME handling ability using the roller pump, with 87.1% volume and 17.8% count reduction across the circuit, compared to A and B with 99.9% volume and 65.8-72.3% count reduction. These findings suggest that, in contrast to A and B, adding CRRT at position C is unsafe and not advised for clinical use.
journal_name
Artif Organsjournal_title
Artificial organsauthors
Shank KR,Profeta E,Wang S,O'Connor C,Kunselman AR,Woitas K,Myers JL,Ündar Adoi
10.1111/aor.12987subject
Has Abstractpub_date
2018-04-01 00:00:00pages
365-376issue
4eissn
0160-564Xissn
1525-1594journal_volume
42pub_type
杂志文章abstract::Methods to predict and control cardiac output (CO) accurately in total artificial heart (TAH) recipients have varied significantly in the last few decades. Early models exhibited minimal control mechanisms and involved fixed pumping parameters. Elaborate electromechanical systems that have recently evolved require int...
journal_title:Artificial organs
pub_type: 杂志文章
doi:
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abstract::The trend in neural prostheses using selective nerve stimulation for electrical stimulation therapies is headed toward single-part systems having a large number of working electrodes (WEs), each of which selectively stimulate neural tissue or record neural response (NR). The present article reviews the electrochemical...
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2004.07341.x
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journal_title:Artificial organs
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12039
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12507
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journal_title:Artificial organs
pub_type: 杂志文章,随机对照试验
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1987.tb02622.x
更新日期:1987-02-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1997.tb00489.x
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1988.tb02813.x
更新日期:1988-12-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2002.06999.x
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2010.01064.x
更新日期:2011-02-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13009
更新日期:2018-03-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2009.00969.x
更新日期:2010-12-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2001.025005331.x
更新日期:2001-05-01 00:00:00
abstract::The aim of this meta-analysis was to determine whether pulsatile perfusion during cardiac surgery has a lesser effect on renal dysfunction than nonpulsatile perfusion after cardiac surgery in randomized controlled trials. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were used to identify ava...
journal_title:Artificial organs
pub_type: 杂志文章,meta分析
doi:10.1111/aor.12452
更新日期:2015-09-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2008.00610.x
更新日期:2008-08-01 00:00:00
abstract::Total artificial hearts (TAHs) and biventricular assist devices (BVADs) have varying levels of acceptance and reliability, and the research on both focuses on their control mechanisms. Efforts generally aim to achieve a response to physiologic demand and left/right output balance, and beneficial cardiac output (CO) an...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1996.tb04438.x
更新日期:1996-03-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.1998.06017.x
更新日期:1998-08-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1988.tb02760.x
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journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12702
更新日期:2016-11-01 00:00:00
abstract::Clinical data from 120 adult patients with genetically undifferentiated polycystic kidney disease who had been followed up for more than 3 months (range 3-172) were reviewed in order to try to identify clinical indicators that might predict deterioration in renal function. They were split into two groups dependent on ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2012.01441.x
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journal_title:Artificial organs
pub_type: 临床试验,杂志文章
doi:
更新日期:1996-06-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章,评审
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更新日期:2002-07-01 00:00:00
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journal_title:Artificial organs
pub_type: 杂志文章
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abstract::Effect of hemodialysis (HD) on some indices of immune response was studied in nine chronic uremics. Total lymphocyte, OKT4+, and OKT8+ cell numbers significantly decreased during the first 20 min of HD, and they were decreased till the third hour of the procedure, whereas the OKT4+/OKT8+ cell number ratio did not chan...
journal_title:Artificial organs
pub_type: 杂志文章
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abstract::The use of recombinant human erythropoietin (rHuEpo) has revolutionized anemia management of early and late stages of chronic kidney disease. Darbopoietin is also now available for the treatment of anemia of chronic kidney disease. In addition, rHuEpo has been used for the treatment of anemia observed in critical illn...
journal_title:Artificial organs
pub_type: 杂志文章,评审
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更新日期:2003-09-01 00:00:00
abstract::Platelet-rich plasma (PRP) contains many growth factors that are involved in tissue regeneration processes. For successful tissue regeneration, protein growth factors require a delivery vehicle for long-term and sustained release to a defect site in order to maintain their bioactivity. Previously, we showed that hepar...
journal_title:Artificial organs
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更新日期:2015-04-01 00:00:00
abstract::The Genius is a convenient single-pass batch hemodialysis system. Dialysate is heated during the preparation phase. Once the container is filled at one of the three available starting temperatures, dialysate cools spontaneously. As dialysate temperature plays an important role in hemodynamic stability, knowledge of th...
journal_title:Artificial organs
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abstract::In this study two aspects of hybrid functional electrical stimulation (FES) orthoses were investigated: joint motion constraints and FES control strategies. First, the effects of joint motion constraints on the gait of normal subjects were investigated using modern motion analysis systems, including electromyogram (EM...
journal_title:Artificial organs
pub_type: 临床试验,杂志文章
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