The impact of pump settings on the quality of pulsatility.

The study objective was to evaluate the Jostra HL-20 roller pump under different baseflow and pump head settings with quantified energy values from pressure and flow waveforms, in a simulated pediatric bypass circuit. Pump flow rate was set at 800 mL/min for both pulsatile and nonpulsatile perfusion modes and the mean arterial pressure (MAP) of the pseudopatient was maintained at 40 mm Hg for each experiment. Pulsatile baseflow settings and pump head start points varied with each experiment. Pressure and flow waveforms were recorded at preoxygenator, precannula, and postcannula sites under each pump setting. A total of 91 experiments were performed (n=7, nonpulsatile; n=84, pulsatile). Increasing baseflow caused decreases in the mean circuit pressure and surplus hemodynamic energy (SHE) levels for all pump head start times. When increasing pump head start time within each baseflow, values for MAP and SHE increased significantly. Regardless of baseflow or pump head start time, values for mean circuit pressure and SHE were lower for nonpulsatile flow than for pulsatile flow. Total hemodynamic energy values were also significantly higher under pulsatile perfusion and increased pump start times while decreasing with increased baseflows in the circuit. This study concludes that decreased baseflows with increased pump head settings on the Jostra HL-20 roller pump could significantly increase quality of generated pulsatile energy. Further research is necessary to evaluate these various pump settings under microembolic loads and with different circuit components.

A hemodynamic evaluation of the Levitronix Pedivas centrifugal pump and Jostra Hl-20 roller pump under pulsatile and nonpulsatile perfusion in an infant CPB model.

The hemodynamic comparison of the Jostra HL-20 and the Levitronix PediVAS blood pumps is the focus this study, where pressure-flow waveforms and hemodynamic energy values are analyzed in the confines of a pediatric cardiopulmonary bypass circuit.The pseudo pediatric patient was perfused with flow rates between 500 and 900 ml/min (100 ml/min increments) under pulsatile and nonpulsatile mode. The Levitronix continuous flow pump utilized a customized controller to engage in pulsatile perfusion with equivalent pulse settings to the Jostra HL-20 roller pump. Hemodynamic measurements and waveforms were recorded at the precannula location, while the mean arterial pressure was maintained at 40 mm Hg for each test. Glycerin water was used as the blood analog circuit perfusate. At each flow rate 24 trials were conducted yielding a total of 120 experiments (n=60 pulsatile and n=60 nonpulsatile).Under nonpulsatile perfusion the Jostra roller pump produced small values for surplus hemodynamic energy (SHE) due to its inherent pulsatility, while the Levitronix produced values of essentially zero for SHE. When switching to pulsatile perfusion, the SHE levels for both the Jostra and Levitronix pump made considerable increases. In comparing the two pumps under pulsatile perfusion, the Levitronix PediVAS produced significantly more surplus and total hemodynamic energy than did the Jostra roller pump each pump flow rate.The study suggests that the Levitronix PediVAS centrifugal pump has the capability of achieving quality pulsatile waveforms and delivering more SHE to the pseudo patient than the Jostra HL-20 roller pump. Further studies are warranted to investigate the Levitronix under bovine blood studies and with various pulsatile settings.

A hemodynamic evaluation of the Medos Deltastream DP1 rotary pump and Jostra HL-20 roller pump under pulsatile and nonpulsatile perfusion in an infant cardiopulmonary bypass model--a pilot study.

This study aims to compare the Jostra HL-20 roller pump to the Medos DeltaStream DP1 rotary pump in terms of pressure and flow waveforms, as well as calculated energies based on pressure/flow relationships, in a simulated pediatric cardiopulmonary perfusion system. The flow rate was set at 1,000 ml/min for each pump, under both pulsatile and nonpulsatile perfusion modes. Mean arterial pressure (MAP) was maintained at 40 mm Hg. Pressure and flow measurements and waveforms were recorded at precannula site in the bypass circuit. Blood analog test fluid was used to simulate blood properties. A total of 24 experiments were performed (n = 12 nonpulsatile and n = 12 pulsatile). A significant increase in surplus hemodynamic energy (SHE) was observed in both pumps under pulsatile perfusion. In contrast, nonpulsatile perfusion generated very little SHE in the Jostra roller pump, whereas no SHE was generated in the Medos rotary pump. However, under pulsatile perfusion, the Medos rotary pump generated more than twice the amount of SHE or "extra" energy than the Jostra roller pump. The total hemodynamic energy was also significantly higher in the Medos rotary pump than the Jostra roller pump, under pulsatile perfusion. This pilot study suggests that the Medos DeltaStream DP1 rotary pump may produce greater hemodynamic energy levels and higher quality physiologic pressure/flow waveforms than the Jostra roller pump. Further investigation of the Medos DeltaStream DP1 rotary pump is necessary to evaluate hemodynamic energy generation under various pump settings, in contrast to different flow rates.