A computerized control system for cardiopulmonary bypass

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A computerized control system for cardiopulmonary bypass Toshiyuki Beppu, MEa, Yasuharu Imai, MDa, Yasuhiro Fukui, PhDb The Journal of Thoracic and Cardiovascular Surgery Volume 109, Issue 3, Pages 428-438 (March 1995) DOI: 10.1016/S0022-5223(95)70273-3 Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 1 Schematic diagram of a computerized CPB system. PA, Pulmonary artery; LA, left atrium; LV, left ventricle; RA, right atrium; RV, right ventricle; SVC, superior vena cava; IVC, inferior vena cava; CVP, central venous pressure; AoP, aortic pressure. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 428-438DOI: (10.1016/S0022-5223(95)70273-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 2 The venous withdrawal flow control method of the computerized CPB system. Venous withdrawal flow at time n [VW(n)] is calculated from an error between CVP and the CVP set point at the time [e(n)], at the preceding time [e (n-1)], and the flow rate before the control time. When an artificial noise is measured on the CVP measurement, the computer holds the venous flow rate constant. At a moment of collapsing of the venae cavae [VW (nc)], the computer stops the venous flow and restarts with a reduced rate [VW (nc')]. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 428-438DOI: (10.1016/S0022-5223(95)70273-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Hemodynamic recordings during computerized CPB (patient 11, female, 1 year, 7.5 kg, 0.38 m2 , tetralogy of Fallot). From top, the tracings show AoP, CVP, and the CVP set point, reservoir blood volume, and infusion flow (IF) and venous withdrawal flow (VW), ECUM, Extracorporeal membrane filtration. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 428-438DOI: (10.1016/S0022-5223(95)70273-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 3 Hemodynamic recordings during computerized CPB (patient 11, female, 1 year, 7.5 kg, 0.38 m2 , tetralogy of Fallot). From top, the tracings show AoP, CVP, and the CVP set point, reservoir blood volume, and infusion flow (IF) and venous withdrawal flow (VW), ECUM, Extracorporeal membrane filtration. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 428-438DOI: (10.1016/S0022-5223(95)70273-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 4 Recordings of perfusion pressures and the flow rates at the onset of computerized CPB (patient 1, male, 9 months, 7.1 kg, 0.36 m2). SVC, Superior vena cava; IF, infusion flow; VW, venous withdrawal flow. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 428-438DOI: (10.1016/S0022-5223(95)70273-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 5 Recordings of venous pressure and flow rates with artificial fluctuations on the venous pressure measurement (patient 9, male, 2 years, 12.3 kg, 0.52 m2). A dashed line on the flow graph showed a virtual response of the venous flow without the screening. IF, Infusion flow; VW, venous withdrawal flow. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 428-438DOI: (10.1016/S0022-5223(95)70273-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 6 Mean AoP during aortic crossclamping and mean CVP during CPB. A, Ventricular septal defect. B, Tetralogy of Fallot. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 428-438DOI: (10.1016/S0022-5223(95)70273-3) Copyright © 1995 Mosby, Inc. Terms and Conditions

Fig. 6 Mean AoP during aortic crossclamping and mean CVP during CPB. A, Ventricular septal defect. B, Tetralogy of Fallot. The Journal of Thoracic and Cardiovascular Surgery 1995 109, 428-438DOI: (10.1016/S0022-5223(95)70273-3) Copyright © 1995 Mosby, Inc. Terms and Conditions