TY - JOUR
T1 - Hemodynamic considerations in the design and attachment mode of an artificial lung
AU - Perlman, C. E.
AU - Boschetti, F.
AU - Cook, K. E.
AU - Mockros, L. F.
PY - 2000
Y1 - 2000
N2 - 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.
AB - 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.
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U2 - 10.1097/00002480-200003000-00176
DO - 10.1097/00002480-200003000-00176
M3 - Conference article
AN - SCOPUS:0034159106
VL - 46
SP - 194
JO - Unknown Journal
JF - Unknown Journal
IS - 2
T2 - 46th Annual Conference and Exposition of ASAIO
Y2 - 28 June 2000 through 1 July 2000
ER -