First serial in vivo results of mechanical circulatory support in children with a new diagonal pump.
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.