点击次数：

论文类型：期刊论文

发表时间：2017-09-21

发表刊物：ASAIO journal (American Society for Artificial Internal Organs : 1992)

收录刊物：SCIE、PubMed

卷号：64

期号：3

页面范围：338-350

ISSN号：1538-943X

关键字：biventricular assist devices; flow balancing; physiologic control; suction prevention; sensor control algorithm

摘要：Rotary biventricular assist devices (BiVAD) are becoming a clinically accepted treatment option for end-stage biventricular failure. To improve BiVAD efficacy and safety, we propose a control algorithm to achieve the clinical objectives of maintaining left-right-sided balance, restoring physiologic flows, and preventing ventricular suction. The control algorithm consists of two proportional-integral (PI) controllers for left and right ventricular assist devices (LVAD and RVAD) to maintain differential pump pressure across LVAD (DeltaPL) and RVAD (DeltaPR) to provide left-right balance and physiologic flow. To prevent ventricular suction, LVAD and RVAD pump speed differentials (DeltaRPML, DeltaRPMR) were maintained above user-defined thresholds. Efficacy and robustness of the proposed algorithm were tested in silico for axial and centrifugal flow BiVAD using 1) normal and excessive DeltaPL and/or DeltaPR setpoints, 2) rapid threefold increase in pulmonary vascular or vena caval resistances, 3) transient responses from exercise to rest, and 4) ventricular fibrillation. The study successfully demonstrated that the proposed BiVAD algorithm achieved the clinical objectives but required pressure sensors to continuously measure DeltaPL and DeltaPR. The proposed control algorithm is device independent, should not require any modifications to the pump or inflow/outflow cannulae/grafts, and may be directly applied to current rotary blood pumps for biventricular support.