Impact of Vacuum-Assisted Venous Drainage on Forward Flow in Simulated Pediatric Cardiopulmonary Bypass Circuits Utilizing a Centrifugal Arterial Pump Head
Carregando...
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2020
Título da Revista
ISSN da Revista
Título do Volume
Editora
SOC BRASIL CIRURGIA CARDIOVASC
Autores
GUIMARAES, Daniel Peres
MATTE, Gregory S.
POLICARPO, Valeria Camargo
CASTRO, Ana Vitoria C. X.
Citação
BRAZILIAN JOURNAL OF CARDIOVASCULAR SURGERY, v.35, n.2, p.134-140, 2020
Resumo
Objective: To analyze the impact of vacuum-assisted venous drainage (VAVD) on arterial pump flow in a simulated pediatric cardiopulmonary bypass circuit utilizing a centrifugal pump (CP) with an external arterial filter. Methods: The simulation circuit consisted of a Quadrox-I Pediatric oxygenator, a Rotaflow CP (Maquet Cardiopulmonary AG, Rastatt, Germany), and a custom pediatric tubing set primed with Lactated Ringer's solution and packed red blood cells. Venous line pressure, reservoir pressure, and arterial flow were measured with VAVD turned off to record baseline values. Four other conditions were tested with progressively higher vacuum pressures (-20, -40, -60, and -80 mmHg) applied to the baseline cardiotomy pressure. An arterial filter was placed into the circuit and arterial flow was measured with the purge line in both open and closed positions. These trials were repeated at set arterial flow rates of 1500, 2000, and 2500 mL/min. Results: The use of progressively higher vacuum caused a reduction in effective arterial flow from 1490 +/- 0.00 to 590 +/- 0.00, from 2020 +/- 0.01 to 1220 +/- 0.00, and from 2490 +/- 0.0 to 1830 +/- 0.01 mL/min. Effective forward flow decreased with increased levels of VAVD. Conclusion: The use of VAVD reduces arterial flow when a CP is used as the main arterial pump. The reduction in the forward arterial flow increases as the vacuum level increases. The loss of forward flow is further reduced when the arterial filter purge line is kept in the recommended open position. An independent flow probe is essential to monitor pump flow during cardiopulmonary bypass.
Palavras-chave
Congenital Heart Disease, Cardiopulmonary Bypass, Child, Vacuum, Drainage, Pressure, Erythrocytes
Referências
- Baker Robert A, 2006, J Extra Corpor Technol, V38, P220
- Caneo LF, 2019, BRAZ J CARDIOVA SURG, V34, P239, DOI 10.21470/1678-9741-2018-0347
- Caneo LF, 2018, BRAZ J CARDIOVA SURG, V33, P224, DOI 10.21470/1678-9741-2018-0074
- Corno AF, 2007, EUR J CARDIO-THORAC, V31, P1044, DOI 10.1016/j.ejcts.2007.01.066
- de Carvalho EB, 2014, REV BRAS CIR CARDIOV, V29, P266, DOI 10.5935/1678-9741.20140029
- DeBois WJ, 1995, J EXTRA-CORP TECHNOL, V27, P77
- Gambino Rachel, 2015, J Extra Corpor Technol, V47, P160
- Hessel EA, 2015, CARDIOPULMONARY BYPA, P19
- Jakob H G, 1991, ASAIO Trans, V37, pM487
- Jatene MB, 2018, AVALIACAO PRATICAS P
- Jegger David, 2003, J Extra Corpor Technol, V35, P207
- Klein M, 1998, ARTIF ORGANS, V22, P326, DOI 10.1046/j.1525-1594.1998.06051.x
- LaPietra A, 2000, J THORAC CARDIOV SUR, V120, P856, DOI 10.1067/mtc.2000.110183
- Matte GS, 2015, PERFUSION FOR CONGENITAL HEART SURGERY: NOTES ON CARDIOPULMONARY BYPASS FOR A COMPLEX PATIENT POPULATION, P1, DOI 10.1002/9781118900925
- Murphy GS, 2009, ANESTH ANALG, V108, P1394, DOI 10.1213/ane.0b013e3181875e2e
- Saczkowski R, 2012, ARTIF ORGANS, V36, P668, DOI 10.1111/j.1525-1594.2012.01497.x
- Sathianathan Shyama, 2020, Artif Organs, V44, P28, DOI 10.1111/aor.13404
- Shade BC, 2020, PERFUSION-UK, V35, P26, DOI 10.1177/0267659119850344
- Triveldi U, 1997, PERFUSION, V12, P67
- Vida VL, 2014, J NEPAL MED ASSOC, V52, P960, DOI 10.31729/jnma.2794
- Wang Shigang, 2008, J Extra Corpor Technol, V40, P249
- Willcox TW, 1999, ANN THORAC SURG, V68, P1285, DOI 10.1016/S0003-4975(99)00721-3