• Title/Summary/Keyword: 혈액 펌프

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Effect of Retrograde Autologous Priming in Adult Cardiac Surgery for Minimizing Hemodilution and Transfusion Requirements (성인개심술에서 혈액희석 및 수혈을 최소화하기 위한 역행성 자가 혈액 충전법의 효과)

  • Kim Kyung-Hwan
    • Journal of Chest Surgery
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    • v.38 no.12 s.257
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    • pp.821-827
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    • 2005
  • Background: Hemodilution after priming of the cardiopulmonary bypass is known to increase the possibility of bleeding and homologous transfusion in adult cardiac surgery. We investigated the effects of retrograde autologous priming (RAP) to see whether it would decrease postoperative bleeding and homologous transfusion. Material and Method: We retrospectively reviewed 34 patients wpho underwent RAP and 46 patients who did not. Retrograde autologous priming consisted of arterial lire drainage, venous reservoir and oxygenator drainage and venous line drainage. We compared the amount of priming solution and RAP volume, perioperative hematocrit, postoperative bleeding and transfusion requirements in the two groups. Resuit: Mean withdrawal volume in RAP group was 613.5$\pm$160.6 mL and initial priming volume was 1381.9$\pm$37.2 mL. Hemoatocrits ($\%$) in RAP and control groups were 25.0$\pm$3.7 vs 20.9$\pm$3.6 (5 minutes after CPB), 25.9$\pm$3.7 vs 22.5$\pm$3.6 (30 minutes after CPB), 25.9$\pm$3.4 vs 23.8$\pm$2.8 (60 minutes after CPB), 31.9$\pm$3.9 vs 31.5$\pm$4.5 (postoperative 1 hour), 32.4$\pm$4.4 vs 32.1$\pm$4.5 (postoperative 6 hours), 33.4$\pm$5.0 vs 31.7$\pm$5.1 (postoperative 1 day)[repeated measures ANOVA, p < 0.05]. Chest tube drainages (mL) in the two groups were 357.2$\pm$177.1 vs 411.7$\pm$279.5 (postoperative 6 hours), 599.4$\pm$145.6 vs 678.8$\pm$256.4 (postoperative 24 hours)[t-test, p < 0.05]. Homologous transfusion was performed in 7 out of 34 patients in RAP group (20.6$\%$), and 16 out of 46 (34.8$\%$) in control group (p < 0.05). Conclusion: This study suggests that the effects of reducing the priming volume during cardiopulmonary bypass may result in lesser bleeding and homologous transfusion. Retrograde autologous priming would be used to reduce postoperative bleeding and chance of transfusion after adult cardiac surgery.

Development and Animal Tests of Pneumatic Ventricular Assist Device (공압식 심실보조장치의 개발 및 동물실험)

  • 박영환;김상현
    • Journal of Chest Surgery
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    • v.30 no.3
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    • pp.247-252
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    • 1997
  • Ten acute and chronic in vivo studies were utilized to develop a pneumatic ventricular assist device (VAD) as a bridge to heart transplantation or a circulatory assist device for patients with end-stage heart disease or poor myocardial funct on after cardiac surgery. Two sizes of blood pump of 70cc for adult patients and 34cc for pediatric patients were implanted in the animals. Ventricle of the blood pump was made from the polyurethaae to enhance antithrombogenecity. The VAD was implanted between the left atrium and the descending aorta. Average flow rate was 2.38 L/min for adult and 0.41 L/min for pediatric VAD at the rate of 60 bum. The duration of support ranged from 1 to 26 hours. The most frequent complication was bleeding. Main causes of death were heart failure and respiratory failure. The device function was good for short term use. Studies to date suggest that, with further refinement, a reliable long term VAD that will have clinical application can be developed.

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Liquid Flow and Pressure Drop of an Outside Flow Membrane Oxygenator with Hollow Fibers (외부흐름 중공사 막형 인공폐의 액체흐름과 압력손실)

  • 이삼철;김기범
    • Journal of Biomedical Engineering Research
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    • v.23 no.1
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    • pp.27-32
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    • 2002
  • The purpose of this study was to evacuate the effects of the number of tied hollow fibers in a novel membrane oxygenator that satisfied the limiting factor of minimizing the friction loss in the intravascular blood flow Pattern. The membrane oxygenator is a bundle consisted of several hundred ho1low fibers haying the outside diameter of 380 $\mu m$ and the axial jacket length of 600 mm. The eight different variation of tied hollow fibers in a bundle were designed. and the liquid flow pattern was controlled by a pump. The liquid pressure drop was measured by in vitro experiments using water and g1ycero1. Uniform blood flow pattern was observed for each number of tied hollow fibers. Pressure drop was 13-16 mmHg outside of the membrane oxygenator consisting of up to 700 ho1low fibers. More effective contact of liquid with the tied ho1low fibers was observed as a decrease in the number of the tied hollow fibers. and resulted in the enhancement of the friction tractor

Characteristics of the Sealing Pressure of a Magnetic Fluid Shaft Seal for Intra-Cardiac Axial Flow Blood Pumps (심장 내 이식형 축류 혈액 펌프용 자성 유체 축봉의 내압 특성)

  • KIM, Dong-Wook;Mitamura , Yoshinori
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.51 no.10
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    • pp.477-482
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    • 2002
  • One of the key technologic requirements for rotary blood pumps is the sealing of the motor shaft. A mechanical seal, a journal bearing, magnetic coupling, and magnetic suspension have been developed, but they have drawbacks such as wear, thrombus formation, and power consumption. A magnetic fluid seal is durable, simple, and non power consumptive. Long-term experiments confirmed these advantages. The seal body was composed of a Nd-Fe-B magnet and two pole pieces; the seal was formed by injecting magnetic fluid into the gap (50${\mu}m$) between the pole pieces and the motor shaft. To contain the ferro-fluid in the seal and to minimize the possibility of magnetic fluid making contact with blood, a shield with a small cavity was attached to the pole piece. While submerged in blood, the sealing pressure of the seal was measured and found to be 31kPa with magnetic fluid LS-40 (saturated magnetization, 24.3 KA/m) at a motor speed of 10,000 rpm and 53kPa under static conditions(0mmHg). The specially designed magnetic fluid seal for keeping liquids out is useful for axial flow blood pumps. The magnetic fluid seal was incorporated into an intra-cardiac axial flow blood pump.

Development of an Inductive Proximity Sensor in Active Magnetic Bearing System for Magnetically Suspended Centrifugal Blood Pumps (능동 자기 베어링 방식의 자기 부상 원심성 혈액 펌프를 위한 유도성 근접 센서 개발)

  • Kim, H.I.;Kim, H.C.
    • Proceedings of the KOSOMBE Conference
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    • v.1998 no.11
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    • pp.245-246
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    • 1998
  • AMB(Active Magnetic Bearing) systems are popularly used in various areas. In biomedical engineering applications it is a key part of magnetically suspended rotary blood pumps. The special advantage of AMBs is that they enable the rotor to revolve with no physical contact and provide rotary blood pumps with better performances such as low hemolysis level. Fundamentally, AMB systems consist of three parts, proximity sensors for distance detection, microprocessor for control algorithm and power amplifiers for actuating electromagnets. We have developed an inductive type proximity sensor with satisfactory characteristics that can be used in AMB systems. Frequency response was flat at least up to 10 kHz and sensitivity, resolution$(>5{\mu}m)$ and sensing range(<5mm) of the sensor could be adjustable for various purposes. The characteristics of the completed model showed to have satisfactory behaviors compared with the commercially available ones that already appeared to have reliable behaviors in AMB systems.

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INVESTIGATION ON MECHANICAL AND BIO-MECHANICAL PERFORMANCE OF A CENTRIFUGAL BLOOD PUMP (혈액 펌프의 기계적 성능과 생체 역학적 성능에 대한 연구)

  • Chang, M.;Moshfeghi, M.;Hur, N.;Kang, S.;Kim, W.;Kang, S.H.
    • Journal of computational fluids engineering
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    • v.20 no.2
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    • pp.88-95
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    • 2015
  • Blood pump analysis process includes both mechanical and bio-mechanical aspects. Since a blood pump is a mechanical device, it has to be mechanically efficient. On the other hand, blood pumps function is sensitively related to the blood recirculation; hence, bio-factors such as hemolysis and thrombosis become important. This paper numerically investigates the mechanical and bio-mechanical performances of the Rotaflow in the extracorporeal membrane oxygenation(ECMO), Ventricular Assist Device(VAD), and full-load conditions. The operational conditions are defined as(400[mmHg], 5[L/min.]), (100[mmHg], 3[L/min.]), and (600[mmHg], 10[L/min.]) for ECMO, VAD, and full-load conditions, respectively. The results are presented and analyzed from the mechanical aspect via performance curves, and from bio-mechanical aspect via focusing on hemolytic characteristics. Regions of top and bottom cavities show recirculation in both ECMO and VAD condtions. In addition, Eulerian-based calculation of modified index of hemolysis(MIH) has been investigated. The results demonstrate that the VAD condition has the least risk of hemolysis among the others, while the full-load condition has the highest risk.

Prediction of Hemolysis in Intra-Cardiac Axial Flow Blood Pumps for Optimization of the Impellers (심장 내 이식형 축류 혈액펌프의 임펠러 최적화를 위한 용혈량 예측)

  • Kim, Dong-Uk;Mitamura, Yoshinori
    • The Transactions of the Korean Institute of Electrical Engineers D
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    • v.51 no.9
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    • pp.431-437
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    • 2002
  • Low hemolysis is one of the key factors in the production of successful rotary blood pumps. It is, however, difficult to identify the areas where hemolysis occurs. Computational fluid dynamics(CFD) analysis enables the engineer to predict hemolysis on a computer Fluid dynamics in five different axial flow pumps was analyzed 3-dimensionally using CFD software. The impeller was rotated at a speed which supplied a flow of 5L/min at a pressure difference of 100mmHg. Changes in the turbulent kinetic energy along streamlines through the pumps were computed. Reynolds' shear stress( (equation omitted) ) was calculated using the turbulent kinetic energy. Hemolysis was evaluated based on Reynolds'shear stress and its exposure time(t) : dHb/Hb=3.62$\times$10$^{-5}$ $t^{0.785}$$\tau$$^{2.416}$ . Hemolysis of the pumps was measured in vitro using fresh bovine blood to which citrate phosphate dextrose was added to prevent clotting. A pump flow of 5L/min was maintained at a pressure difference of 100mmHg for 3h. The normalized index of hemolysis(NIH) as measured. Reynolds' shear stress was high behind the impellers. The measured NIH and the calculated hemolysis(dHb/Hb) shoed a good correlation; NIH=0.0003(dHb/Hb) (r=0.90, n=6) in the range of NIH between 0.003 and 1.1. CFD analysis can predict the in vitro results of hemolysis as well as the areas where hemolysis occurs.ysis occurs.

Improvement of Convection by Pulsatile Blood Pump in High Flux Hemodialysis System (고 유량 혈액 투석 시스템에서 박동류 펌프에 대한 대류 향상에 관한 연구)

  • Choi, D.S.;Um, K.M.;Lee, J.C.;Lee, S.R.;Mun, C.H.;Choi, H.;Min, B.G.;Kim, H.C.
    • Journal of Biomedical Engineering Research
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    • v.29 no.5
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    • pp.376-383
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    • 2008
  • High-flux dialysis treatment removes various toxins via diffusion as well as convection, which is induced by ultrafiltration and backfiltration. In this study, in vitro (Using the distilled water and the bovine's blood) comparison test was performed to determine whether utilization of a high flux dialyzer paired with different pumps would increase the efficiency of convection. At the same blood flow rates, a pulsatile pump and a roller pump were employed to propel the distilled water and bovine whole blood to a high flux dialyzer. Pressures at the dialyzer inlet and outlet in the blood circuit and in the dialysate circuit were measured, respectively. From these data, we calculated the transmembrane pressure and predicted the ultrafiltration and backfiltration rates developed by both pumps. Using the bovine's blood experiment, ultrafiltration and backfiltration rates were 1.6 times higher with the pulsatile pump than with the roller pump. We conclude that utilization of a pulsatile pump in high flux hemodialysis treatments increases ultrafiltration volume, compared with a roller pump under conditions of the same blood flow rate.

A Study on An Integrated GEO/TES with Geothermal Heat Exchanger and Thermal Ice Storage (지중열 교환기와 빙축열조(Thermal Ice Storage)를 연계시킨 통합 지중열-빙축열조 시스템(Integrated GEO/TES))

  • Lohrenz ED.;Hahn Jeongsang;Han Hyuk Sang;Hahn Chan;Kim Hyoung Soo
    • Economic and Environmental Geology
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    • v.38 no.6 s.175
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    • pp.717-729
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    • 2005
  • Peak cooling load of large buildings is generally greater than their peak heating load. Internal and solar heat gains are used fur selection of adquate equipment in large building in cold winter climate like Canada and even Korea. The cost of geothermal heat exchanger to meet the cooling loads can increase the initial cost of ground source heat pump system to the extend less costly conventional system often chosen. Thermal ice storage system has been used for many years in Korea to reduce chiller capacity and shift Peak electrical time and demand. A distribution system designed to take advantage of heat extracted from the ice, and use of geothermal loop (geothermal heat exchanger) to heat as an alternate heat source and sink is well known to provide many benifits. The use of thermal energy storage (TES) reduces the heat pump capacity and peak cooling load needed in large building by as much as 40 to $60\%$ with less mechanical equipment and less space for mechanical room. Additionally TES can reduce the size and cost of the geothermal loop by 1/3 to 1/4 compared to ground coupled heat pump system that is designed to meet the peak heating and cooling load and also can eliminate difficuties of geothermal loop installation such as space requirements and thermal conditions of soil and rock at the urban area.

Redo CABG Using Various Arterial Grafts (다양한 동맥도관을 이용한 재관상동맥 우회술)

  • Min, Ho-Ki;Lee, Young-Tak;Lee, Min-A;Kim, Wook-Sung;Park, Pyo-Won;Sung, Ki-Ick;Jun, Tae-Gook;Yang, Ji-Hyuk
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.456-463
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    • 2009
  • Background: Although the reports on re-operative coronary revascularization (redo-CABG) have increased, there are only limited reports on redo-CABG using arterial grafts. The aim of this study was to analyze the safety and feasibility of using various arterial grafts for redo-CABG. Material and Method: A consecutive series of patients who underwent 33 redo-CABGs from March 2001 to July 2008 were retrospectively reviewed. We performed conventional CABG in 17 patients, on-pump beating CABG in 7, off-pump CABG in 7 and minimally invasive direct coronary artery bypass in 2. The grafted that were used included 34 internal thoracic arteries (ITA), 14 radial arteries, 14 right gastroepiploic arteries and others. Arterial composite grafts were constructed in 26 patients. Of these, a previously patent in-situ left ITA was re-used as the in-flow of a composite graft in 10 patients. Result: No hospital deaths or major wound problems occurred. The post-operative complications included 2 myocardial infarctions (6%), 1 intra-aortic balloon pump insertion (3%), 5 cases of atrial fibrillation (15.1 %) and 3 neurologic complications (9.1%). The meanfollow-up duration was 31.1$\pm$22.7 months and the 3 year survival rate was 86.4%. There were 4 late deaths (2 cardiac deaths) and no recurrent angina during the follow-up period. Conclusion: Redo-CABG with using various arterial grafts is currently a safe, feasible procedure, but further investigation and long term follow-up are needed.