Hemodynamic considerations in the design and attachment mode of an artificial lung

C. E. Perlman, F. Boschetti, K. E. Cook, L. F. Mockros

Research output: Contribution to journalConference articlepeer-review

Abstract

Attachment of an artificial lung (AL) to the pulmonary circulation is anticipated to benefit the treatment of acute or chronic pulmonary disease. AL use would be appropriate when conventional ventilation becomes ineffective or damaging. A numerical model has been developed to predict the hemodynamic consequences of different AL attachment modes and designs in the wide range of possible pathologies. Hemodynamics, in turn, affect blood oxygenation and right ventricular (RV) mechanics, two competing concerns. The model employs compliant chambers and conductant links, some with valves, to represent the major elements of the systemic and pulmonary circulations and the AL. The model includes reactive right and left ventricles and blood pressure feedback from the autonomic nervous system, renin-angiotensin system and renal volume control mechanism. The cardiac chamber compliances vary with time and drive the system. Oxygen supply to and utilization by the RV free wall are compared to predict possible ischemia. Several pathologies are modeled including one that is extreme with respect to imposed RV load, with pulmonary vascular resistance five times normal and pulmonary arterial compliance 0.7 times normal. In this hemodynamically severe disease state only implantation of an AL in-parallel with the natural lungs (NL) enables the heart to maintain sufficient cardiac output, 4.5 1/min compared with 3.5 l/min in other attachment modes, and avoids RV ischemia. No reasonable alteration to AL design would much improve the feasibility of an alternate attachment configuration. Gradual flow rerouting would favorably minimize autonomic stimulation. Combined AL-NL oxygenation efficacy is assessed.

Original languageEnglish
Pages (from-to)194
Number of pages1
JournalUnknown Journal
Volume46
Issue number2
DOIs
StatePublished - 2000
Event46th Annual Conference and Exposition of ASAIO - New York, NY, USA
Duration: 28 Jun 20001 Jul 2000

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