Surgery – Truss – Perineal
Patent
1985-04-04
1987-05-05
Vrablik, John J.
Surgery
Truss
Perineal
623 3, A61M 103
Patent
active
046623558
DESCRIPTION:
BRIEF SUMMARY
The invention relates to a device and to a process for regulating a pump.
It applies more particularly but not exclusively, in the medical field, to the regulation of the by-pass circuit of a "left vent" system or of an artificial kidney or more especially of a left side assistance system possibly coupled to a right side assistance system, whether the flow in the circuit is continuous or pulsed.
Although left ventricle by-passes were recognized very soon as being full of promise in the treatment of serious cardiogenic shock, present techniques are in general insufficient for treating cardiogenic shocks following a massive myocardium incompetence met with in "post extra-corporal circulation" commonly called "post-C.E.C".
Only a left side assistance system, possibly associated with a right side assistance system may ensure the perfusion of the peripheral tissues providing balance favorable to possible recovery of the myocardium.
The beneficial effects of this new balance between the assistance and the energy demand have been demonstrated on animals.
It is in fact the complete discharge of the left ventricle, for which the assistance device is substituted, which provides an improvement in the perfusion characteristics of the myocardium. The balance thus obtained provides then:
high level coronary perfusion,
a reduction of the volume of the ventricle and of the sub endocardial pressure and,
a reduction in the consumption of oxygen because no external work is accomplished by the heart.
The left side assistance is then meant for sick persons who, because of the state of the myocardium, cannot be weaned from the "C.E.C" despite the use of catecholamines and of the intra-aortic counter-pulse.
Left side assistance for several days allows the myocardium then to recover. Such assistance for several days has also allowed 50% of sick people of this type to be weaned.
The flow in the circuit may be continuous but in the present state of knowlede, it seems important to provide a pulsed flow for several reasons such as
attenuation of the response to stress of extra corporal circulation (C.E.C) by reducing the release of catecholamines with as a result:
reduction of the systemic vascular resistances and so a reduction of the cardiac work,
reduction of the suprarenal hypophyseal hormone releases.
Such a left side assistance circuit obviously requires the left auricle pressure, called hereafter "POG" to be monitored for sudden flow, pressure and volemie variations would not be borne very well by patients under cardiogenic shock.
Moreover, if the pressure becomes negative, by a suction effect which occurs, a risk of collapse of the pulmonary veins would appear and so a risk of air embolism.
The advantage of automatic regulation is all the greater since these circuits are generally put in place for several days.
During all this time the circuit must be monitored so as to avert all dangers such as hyper pressure, line breakage, clogging of the filter, air embolism.
It is then inconceivable to use them without having the security, in particular, of automatic regulation and alarms.
For ensuring an even blood flow but also for avoiding the accidents mentioned above, one result which the invention aims to obtain is a device which regulates the blood flow in the organism and so which, in the example chosen, regulates the left ventricle by-passes and which if need be, may also drive a simultaneous right ventricle by-pass circuit.
For this, it provides a regulating device for a pump which is particularly characterized in that it comprises:
means for recording the real pressure of the organ called hereafter "P.O.G"
means for recording a reference pressure,
means on the one hand for comparing the P.O.G. with the reference pressure and, on the other hand, for emitting a signal proportional to the error,
ports for controlling the threshold of this error signal,
alarms controlled by the signal passing through at least one of said ports.
The invention also relates to a process for regulating this pump.
The invention will be better understoo
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patent: 4493693 (1985-01-01), Bilsted et al.
patent: 4540399 (1985-09-01), Litzie et al.
Delecroix Michel
Logier Regis
Pieronne Alain
Soots Georges
Olds Theodore
Vrablik John J.
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