Abstract:
:Technological innovations in pediatric extracorporeal life support circuits can reduce system-related complications and may improve patients' outcome. The Deltastream DP3 (Medos Medizintechnik AG, Stolberg, Germany) is a novel rotational pump with a diagonally streamed impeller that can be used over a broad range of flows. We collected patient data from seven pediatric centers to conduct a retrospective cohort study. We examined 233 patients whose median age was 1.9 (0-201) months. The DP3 system was used for cardiopulmonary support as veno-arterial extracorporeal membrane oxygenation (ECMO) in 162 patients. Respiratory support via veno-venous ECMO was provided in 63 patients. The pump was used as a ventricular assist device in eight patients. Median supporting time was 5.5 (0.2-69) days and the weaning rate was 72.5%. The discharge home rate was 62% in the pulmonary group versus 55% in the cardiac group. Extracorporeal cardiopulmonary resuscitation was carried out in 24 patients (10%) with a survival to discharge of rate of 37.5%. About 106 (47%) children experienced no complications, while 33% suffered bleeding requiring blood transfusion or surgical intervention. Three patients suffered a fatal cerebral event. Renal replacement therapy was performed in 28% and pump or oxygenator exchange in 26%. Multivariable analysis identified system exchange (OR 1.94), kidney failure (OR 3.43), and complications on support (OR 2.56) as risk factors for dismal outcome. This novel diagonal pump has demonstrated its efficacy in all kinds of mechanical circulatory and respiratory support, revealing good survival rates.
journal_name
Artif Organsjournal_title
Artificial organsauthors
Stiller B,Houmes RJ,Rüffer A,Kumpf M,Müller A,Kipfmüller F,Köditz H,Herber Jonat S,Schmoor C,Benk C,Tibboel D,Fleck Tdoi
10.1111/aor.13016subject
Has Abstractpub_date
2018-04-01 00:00:00pages
377-385issue
4eissn
0160-564Xissn
1525-1594journal_volume
42pub_type
杂志文章,多中心研究abstract::We compared in vitro rates of hemolysis for a recently developed centrifugal pump with a conventional roller pump (10-10-00; Stöckert, Munich, Germany). Flow rates of 0.3 L/min and 1 L/min and a pressure of 200 mm Hg were chosen to simulate conditions during neonatal extracorporeal membrane oxygenation (ECMO). There w...
journal_title:Artificial organs
pub_type: 杂志文章
doi:
更新日期:1996-06-01 00:00:00
abstract::The aim of this study was to develop procedures for the diagnosis and nonsurgical management of decreased insulin flow in an implantable programmable pump for long-term intraperitoneal or intravenous insulin delivery featuring a sideport. Patency of the catheter lumen was tested by measuring the time needed for sidepo...
journal_title:Artificial organs
pub_type: 临床试验,杂志文章
doi:10.1111/j.1525-1594.1996.tb04586.x
更新日期:1996-09-01 00:00:00
abstract::Extracorporeal membrane oxygenation (ECMO) has long been the sole means of mechanical support for pediatric patients with end-stage cardiac failure, but has a high waitlist mortality and a reported survival to hospital discharge of less than 50%. The purpose of this study was to compare waitlist mortality and survival...
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
abstract::The weight gain of IVOX devices removed from the first 49 human clinical trials patients after from 1 to 29 days of implantation into the venae caval blood stream has been assessed. Each patient had received sufficient systemic heparin to maintain activated clotting times between 150 and 200 s while the IVOX device wa...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1994.tb03329.x
更新日期:1994-11-01 00:00:00
abstract::The design criteria of an extracorporeal circuit suitable for pulsatile flow are quite different and more entangled than for steady flow. The time and costs of the design process could be reduced if mutual influences between the pulsatile pump and other extracorporeal devices were considered without experimental trial...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2003.47197.x
更新日期:2004-02-01 00:00:00
abstract::The combination of plasma exchange and continuous hemofiltration was applied to patients with acute liver failure, and its clinically advantageous effects were evaluated. This procedure was found to be a powerful approach in decreasing patient morbidity; however, the effect was temporary and the patients finally died....
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1994.tb02217.x
更新日期:1994-05-01 00:00:00
abstract::This paper discussed issues of ethical assessment and moral concern associated with organ replacement and physical enhancement: research, allocation, organ donation, artificial organs, xenografts, biomaterials, and neuromaterials. While emphasizing the medical and moral benefits over associated risks, it calls for a b...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1995.tb02362.x
更新日期:1995-05-01 00:00:00
abstract::Five typical mechanical heart valves (Starr-Edwards, Björk-Shiley convexo-concave (c-c), Björk-Shiley monostrut, Bicer-Val, and St. Jude Medical) were tested in the mitral position under the pulsatile flow condition. The test program included measurements of velocity and turbulent stresses at 5 downstream locations. T...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1997.tb00451.x
更新日期:1997-10-01 00:00:00
abstract::The postdialysis levels of serum sodium concentration, urea concentration, and osmolality, as well as the magnitude of both transcellular fluid shifts and sodium removal, were predicted based on computer modeling without measuring body fluid volumes. A 4-h hemodialysis was performed in five patients at a constant ultr...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1983.tb04219.x
更新日期:1983-11-01 00:00:00
abstract::We aimed to investigate whether acellular endocardium can be used as a useful biomaterial for the intima of engineered small-caliber vascular grafts. Fresh endocardium was harvested from the swine left atrium and was decellularized by digestion with the decellularization solution of Triton X-100 and SDS containing DNa...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12814
更新日期:2016-12-01 00:00:00
abstract::In an effort to improve and automate the fluid dynamic design of rotary blood pumps, a coupled computational fluid dynamics (CFD) shape optimization methodology has been developed and implemented. This program couples a finite element flow simulation with a gradient-based optimization routine to modify automatically t...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1995.tb02389.x
更新日期:1995-07-01 00:00:00
abstract::Malfunction of bileaflet mechanical heart valves in the mitral position could either be due to patient-prosthesis mismatch (PPM) or leaflet obstruction. The aim of this article is to investigate the validity of current echocardiographic criteria used for diagnosis of mitral prosthesis malfunction, namely maximum veloc...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12653
更新日期:2016-05-01 00:00:00
abstract::As a preliminary investigation to establish a cryopreservation method suited for bioartificial livers (BALs), three-dimensional (3-D) cryopreservation experiments with fibroblasts were performed, in which the cells were firstly seeded into a porous scaffold, and the scaffold containing the cells was then cryopreserved...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2009.00933.x
更新日期:2010-07-01 00:00:00
abstract::The aim of this study was to characterize and compare human great saphenous veins (HGSVs), HGSV cryoallografts, expanded polytetrafluoroethylene (ePTFE) segments, and elastic and muscular arteries' biomechanics, so as to identify if the biomechanical coupling and the HGSV advantages with respect to ePTFE depend on the...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2007.00467.x
更新日期:2007-11-01 00:00:00
abstract::Cardiovascular disorders are the leading causes of mortality and morbidity in the developed world. Cell-based modalities have received considerable scientific attention over the last decade for their potential use in this clinical arena. This review was intended as a brief overview on the subject of therapeutic potent...
journal_title:Artificial organs
pub_type: 杂志文章,评审
doi:10.1111/j.1525-1594.2006.00209.x
更新日期:2006-04-01 00:00:00
abstract::Modeling different treatment options before a procedure is performed is a promising approach for surgical decision making and patient care in heart valve disease. This study investigated the hemodynamic impact of different prostheses through patient-specific MRI-based CFD simulations. Ten time-resolved MRI data sets w...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12955
更新日期:2018-01-01 00:00:00
abstract::Implantable ventricular assist devices have proven efficacious as a bridge to transplantation and as a bridge to recovery. Although current indications for use of assist devices are somewhat limited, they are likely to expand in the upcoming years, including their use as destination therapy for end-stage heart failure...
journal_title:Artificial organs
pub_type: 杂志文章,评审
doi:10.1046/j.1525-1594.2002.07122.x
更新日期:2002-11-01 00:00:00
abstract::Transcatheter aortic valve implantation (TAVI) has gained considerable acceptance in the past decade due to its lower risks than conventional open-heart surgery. However, the deformation and delamination of the leaflets during the crimping procedure have raised questions about the durability and long-term serviceabili...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13503
更新日期:2019-10-01 00:00:00
abstract::Clinically, the percutaneous transcatheter aortic valve (TAV) has been reported to be deformed in a noncircular configuration after its implant. The deformation is universal and various, and it leads to serious leakage and durability problems. Even in the same deformation, the leaflets made in different tissue thickne...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12833
更新日期:2017-08-01 00:00:00
abstract::The use of Berlin Heart EXCOR VAD (BH) is a validated therapy to bridge pediatric patients to heart transplant. Serial echocardiographic (ECHO) assessment of VAD patients is necessary to support patients' management. This work aims at developing an innovative strategy to evaluate the BH device functioning by ECHO and ...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.13122
更新日期:2018-04-01 00:00:00
abstract::Options for mechanical circulatory support for the treatment of end-stage heart failure in children are limited. Ventricular assist devices (VADs), which have revolutionized cardiac care in adults, remain largely unavailable for pediatric applications. The PediPump is a new rotary dynamic VAD designed to provide suppo...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2005.29088.x
更新日期:2005-07-01 00:00:00
abstract::In 1976, the authors became the codevelopers of the first successful bileaflet heart valve which has become the standard in valvular surgery. However, there still remains a significant rate of thromboembolism and thrombosis which can be attributed to the inherent design of cavities in the pivot area. These cavities co...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1046/j.1525-1594.2002.06999.x
更新日期:2002-05-01 00:00:00
abstract::In total, 30 patients suffering from familial hypercholesterolemia, resistant to diet and lipid-lowering drugs, were treated for up to 6 years (3.6 + or - 1.6; range, 0.2-6.8 years) with low-density lipoprotein (LDL) apheresis. Three different systems were used; the dextran sulfate adsorption system (Kaneka) for 27 of...
journal_title:Artificial organs
pub_type: 临床试验,杂志文章
doi:10.1111/j.1525-1594.1996.tb04455.x
更新日期:1996-04-01 00:00:00
abstract::To expand the usage of the centrifugal pump (CP) in open heart surgery, we performed two studies. In the first, we evaluated pulsatile flow in the CP. In vitro pump performance of the Terumo Capiox pump (TCP) and the Sarns Delphin pump (SDP) and increase of free hemoglobin (mg/dl) after driving 6 h were investigated u...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1994.tb03393.x
更新日期:1994-09-01 00:00:00
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 HL...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12987
更新日期:2018-04-01 00:00:00
abstract::Cell exclusion is the phenomenon whereby the hematocrit and viscosity of blood decrease in areas of high stress. While this is well known in naturally occurring Poiseuille flow in the human body, it has never previously been shown in Couette flow, which occurs in implantable devices including blood pumps. The high-she...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.2012.01561.x
更新日期:2013-03-01 00:00:00
abstract::The major restrictions to the transport of solute and solvent across the peritoneum are the limited peritoneal blood flow, area and permeability. Recent investigations have demonstrated that several vasoactive drugs influence transport parameters. Isoproterenol, nitroprusside, dipyridamole and dopamine exemplify drugs...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1979.tb01052.x
更新日期:1979-08-01 00:00:00
abstract::The compliance problem represents a major obstacle in the development of implantable blood pumps. The motor-driven pumps are enclosed in an airtight casing with gas in the motor space. The trapped gas in the motor space either increases the load on the motor during systole or impedes blood sac filling. Potential solut...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1984.tb04248.x
更新日期:1984-02-01 00:00:00
abstract::Four hundred and forty-two serum ferritin determinations were performed in 144 patients on chronic intermittent hemodialysis treatment with intravenous iron substitution and/or oral iron substitution. Iron substitution should be done individually according to regular serum ferritin determinations. Intravenous iron sub...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/j.1525-1594.1981.tb03980.x
更新日期:1981-05-01 00:00:00
abstract::Neurologic complications during neonatal extracorporeal life support (ECLS) are associated with significant morbidity and mortality. Gaseous microemboli (GME) in the ECLS circuit may be a possible cause. Advances in neonatal circuitry may improve hemodynamic performance and GME handling leading to reduction in patient...
journal_title:Artificial organs
pub_type: 杂志文章
doi:10.1111/aor.12908
更新日期:2017-04-01 00:00:00