Arrangement with a Blood Pump and Pump Control Unit
20210046228 ยท 2021-02-18
Inventors
Cpc classification
A61M2205/3341
HUMAN NECESSITIES
A61M60/237
HUMAN NECESSITIES
A61M60/531
HUMAN NECESSITIES
A61M60/113
HUMAN NECESSITIES
A61M2230/04
HUMAN NECESSITIES
International classification
Abstract
An arrangement for extracorporeal life support is further developed in such a way that a pump actuating signal produces a wave-like surging and subsiding pump output for a pulsatile flow. The pump is preferably a non-occlusive blood pump, such as a diagonal pump, for example. In a preferred variant of embodiment the control signal is provided by an ECG. This allows the diastolic pressure to be increased in order to improve the oxygen balance of the heart muscle.
Claims
1. (canceled)
2. An extracorporeal life support system comprising: a blood line set configured to be connected to a patient for receiving blood from the patient and returning the blood to the patient; a single blood pump connected to the blood line set and configured to pump the blood through the blood line set; an ECG device for measuring a cardiac cycle of the patient; and a pump control unit configured to be connected to (i) the ECG device for receiving a control signal from the ECG device and (ii) the single blood pump for transmitting a pump actuating signal to the single blood pump, wherein the pump actuating signal is configured to cause the single blood pump to generate a pulsatile blood flow that overlaps with a base blood flow, and the pump actuating signal is configured, based on the control signal received from the ECG device, to cause the single blood pump to generate the pulsatile blood flow in a manner such that the pulsatile blood flow is present during a diastole phase of the cardiac cycle of the patient and is no longer present at a start of a subsequent systole phase of the cardiac cycle of the patient.
3. The extracorporeal life support system of claim 2, wherein the pump actuating signal is configured to operate the single blood pump at an increased speed to generate the pulsatile blood flow during the diastole phase of the cardiac cycle of the patient.
4. The extracorporeal life support system of claim 2, wherein the control signal is a variable control signal that varies over time.
5. The extracorporeal life support system of claim 2, wherein the base flow is a laminar base flow.
6. The extracorporeal life support system of claim 2, wherein the single blood pump is a non-occlusive blood pump.
7. The extracorporeal life support system of claim 2, wherein the single blood pump is a diagonal blood pump.
8. The extracorporeal life support system of claim 2, further comprising an oxygenator, the single blood pump being configured to pump the blood to the oxygenator.
9. The extracorporeal life support system of claim 2, wherein the pump control unit is configured to record the control signal received from the ECG device.
10. The extracorporeal life support system of claim 2, wherein the pump control unit comprises a computer configured to convert the control signal into the pump actuating signal.
11. The extracorporeal life support system of claim 2, further comprising an arterial pressure sensor.
12. The extracorporeal life support system of claim 2, wherein the blood line set comprise an arterial cannula for receiving the blood from the patient, the arterial cannula having a length greater than 20 cm.
13. The extracorporeal life support system of claim 12, wherein the arterial cannula has a length greater than 30 cm.
14. The extracorporeal life support system of claim 12, wherein the arterial cannula has a length of 30-35 cm.
15. The extracorporeal life support system of claim 12, wherein the arterial cannula has a length of 35-40 cm.
16. The extracorporeal life support system of claim 12, wherein the blood line set further comprises a venous cannula.
17. The extracorporeal life support system of claim 2, wherein the pump actuating signal is configured to cause the single blood pump to generate the pulsatile blood flow within a time window that is dependent on a heart rate of the patient.
18. The extracorporeal life support system of claim 2, wherein the pump actuating signal is configured to cause the single blood pump to operate at accelerated speed for a defined period within a maximum time window which is dependent on a current heart rate of the patient.
19. The extracorporeal life support system of claim 2, wherein the pump actuating signal is configured to ensure precise emission of the pulsatile flow in the diastole phase of the cardiac cycle of the patient.
20. The extracorporeal life support system of claim 2, wherein the control signal received from the ECG device is provided by a clock generator in accordance with a predetermined rhythm.
21. The extracorporeal life support system of claim 20, wherein the clock generator is a recorded R wave recorded by the ECG device.
22. An extracorporeal life support method comprising: receiving, by a pump control unit, a control signal from an ECG device connected to a patient; and transmitting, by the pump control unit, a pump actuating signal to a single blood pump connected to a blood line set connected to the patient to generate a pulsatile blood flow that overlaps with a base blood flow, the pump actuating signal being based on the control signal received from the ECG device, the pulsatile blood flow being present during a diastole phase of a cardiac cycle of the patient and no longer present at a start of a subsequent systole phase of the cardiac cycle of the patient.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0026]
[0027]
DETAILED DESCRIPTION
[0028] Essential elements of the arrangement 1 are a first blood pump 1, a pump control unit 2 and a computer 3, as shown in
[0029] Via the lead 6, the pump control unit 2 is connected to the first pump 1 and a further pump 7, as shown in
[0030] Finally, in each case a pulsatile flow can also be achieved with the first pump 1 upstream of the oxygenator 8 and the second pump 7 downstream of the oxygenator. Because of the distance between the pumps, this makes it possible to overlap time-delayed waves or to control the pumps with time delayed signals.
[0031] Together with the oxygenator 8, the pumps 1 and 7 are arranged in a housing 9. This permits a simple construction. In the shown example of embodiment only one lead 6 runs from the pump control unit 2 to the housing 9 in order in the housing 9 to provide the two pumps 1 and 7 with a pump actuating signal. As an alternative one lead can be taken to the first pump 1 and a further lead to the second pump 7.
[0032] As a blood pump a diagonal pump is used, at least for the first pump 1. Preferably both pumps 1 and 7 are diagonal pumps. However, axial or centrifugal pumps can also be used.
[0033] The control signal 4 is provided by an ECG 10 which is connected to the patient 12 via a cable 11.
[0034] Located in the blood circulation or heart of the patient 12 are a venous cannula 13 and an arterial cannula 14. The arterial cannula is around 35-40 cm, preferably 30 to 45 cm, in length and the venous cannula is introduced into the vena cava.
[0035] During operation of the ECLS system, with the ECG 10, via the lead 11 an ECG signal of a patient 12 is recorded in order to generate a control signal 4. This control signal 4 is converted by the computer 3 into a pump signal 5 which, via the pump control unit 2 and lead 6 controls the pumps 1 and 7 or provides them with a current. A console 15 is used which emits a software trigger to start the blood pump 1 in accordance with a specially developed algorithm with the aim of emitting impulses into the systole and/or the diastole.
[0036] For this the ECG signal is implemented in the console. The user interface is adapted in order to create settings options for the ECG and to constitute a marker channel to show the relevant action of the blood pump as a sense or pulse.
[0037] In the blood circulation 16 from the venous cannula 13 to the arterial cannula 14 the blood is enriched with oxygen in the oxygenator 8 and CO.sub.2 is removed.
[0038] The blood pump 1 is accelerated by a special value on top of the base speed for a defined period within a maximum time window which is dependent on the current heart frequency. The time limitation takes place by way of a further algorithm.
[0039] The blood pump or blood pump 1 and 7 are controlled in such a way that a diastolic augmentation occurs. During this heart action the coronary perfusion pressure is increased. The end-diastolic blood pressure in the area of the aorta close to the heart then falls to a lower value than normal. The following systole has less ejection resistance to overcome and is therefore known as an influenced systole. The lower afterload can be seen in the lower systolic pressure.
[0040] By increasing the diastolic pressure the oxygen balance of the heart muscle is improved in two ways: the myocardial oxygen supply is increased by a rise in the coronary perfusion pressure and at the same time the mechanical heart action and thereby the myocardial oxygen consumption are decreased. In this way the preconditions for recovery of the heart are improved.
[0041] One problem of oxygenators is clotting, whereby the constituents of the blood are deposited on the gas exchange membrane. In addition, clots can form in areas of the oxygenator where there is little flow. Through the pulsatile flow through the oxygenator the flow in the oxygenator changes, as a result of which the service life of the oxygenator is improved.
[0042] Furthermore, as a side effect the gas exchange is improved as the boundary layer between fibres and the flowing blood is reduced.