Biomedical subjects

Y Taenaka

Publications and source records attributed to Y Taenaka.

At least 127 records · Page 7Linked to original sources

PubMedDate not supplied

Influence of non pulsatile systemic circulation on tissue blood flow and oxygen metabolism.

Influence of non pulsatile systemic circulation on oxygen metabolism was examined regarding tissue perfusion in 12 adult goats weighing from 46 to 55 kg. Under general anesthesia, a flow character, changeable total left heart bypass circuit consisting of pulsatile and non pulsatile pumps was installed through a left thoracotomy. Systemic flow was converted from pulsatile to non pulsatile in 7 of 12 animals, and in the reverse order in the other 5, by changing the driving pump. Esophageal mucosal blood flow was determined by a colored microsphere method that estimated tissue blood flow at the pre capillary level. Esophageal intramucosal pH was evaluated with a silicone balloon tonometer catheter surgically placed in the submucosal space. Hemodynamic and arterial blood gas parameters were unchanged at flow mode conversion. Although oxygen delivery was comparable between pulsatile and non pulsatile circulation, oxygen extraction ratio was lower and venous oxygen saturation was higher in non pulsatile than pulsatile circulation. Although statistically not significant, serum lactate level tended to be higher with non pulsatile circulation. No difference was observed in esophageal mucosal blood flow between pulsatile and non pulsatile circulation, whereas intramucosal pH, which strongly correlated with arterial pH regardless of the flow mode, was significantly lower under non pulsatile than pulsatile conditions. In conclusion, systemic oxygen uptake is less efficient in non pulsatile than pulsatile circulation in the setting of an acute experiment using animals, which may be accounted for by the disparity between the pre capillary blood flow and actual tissue oxygen metabolism.

Animals↗

PubMedDate not supplied

Importance of metabolic function of the natural lung evaluated by prolonged exclusion of the pulmonary circulation.

It is generally considered that the natural lung metabolizes various vasoactive substances through the pulmonary circulation. However, the influences of bypassing or eliminating the pulmonary circulation have not been fully elucidated, especially for prolonged periods. In this study, we performed total cardiopulmonary bypass and exclusion of the pulmonary circulation for up to 336 hr in awake goats to clarify the importance of the metabolic function of the lung. In seven adult goats, biventricular bypass with a pulsatile ventricular assist system was first established. After 2 weeks, the biventricular bypass was converted to total cardiopulmonary bypass without anesthesia. Adequate gas exchange and perfusion support were achieved in all animals. However, the institution of total cardiopulmonary bypass led to marked decreases in the mean aortic pressure and systemic vascular resistance, and they remained low thereafter. The arterial levels of prostaglandin E2 and norepinephrine, which are inactivated naturally through the pulmonary circulation, increased remarkably. These results indicate that the natural lung plays an important role in controlling systemic circulation by metabolizing various vasoactive substances. Understanding the non respiratory function of the natural lung is of prime importance for advancement of lung and heart-lung support.

Animals↗

PubMedDate not supplied

Development of an integrated artificial heart-lung device for long-term cardiopulmonary support.

An integrated artificial heart-lung device has been developed as a long-term cardiopulmonary support system. The device is composed of gas exchange and pumping units. The gas exchange unit consists of a special hollow fiber membrane that can prevent serum leakage. The entire blood contacting surface of the gas exchange unit is treated with covalent heparin bonding. The pumping unit consists of two pusher-plate artificial hearts joined to each end of the artificial lung unit. The core size and priming volume of the device are 11 x 14 x 17 cm and 400 ml, respectively. In in vitro evaluation, the device exhibited a maximum output of 7.0 L/ min, with a pressure gradient of 10 mmHg per 1 L/min flow rate. In acute in vivo evaluation with adult goats, the device satisfactorily replaced the animals' circulation and respiration for 6 hr. Pumping output ranged from 5.5 to 6.0 L/min, whereas PaO2 and PaCO2 were kept above 500 mmHg and below 30 mmHg, respectively. The device demonstrated prominent thrombus resistant properties in nonheparin animal use trials. These results indicate that the integrated artificial heart-lung device has a potential to be a long-term cardiopulmonary support system that can be used with minimal anticoagulant therapy.

Animals↗

PubMedDate not supplied

Development of a membrane oxygenator for long-term respiratory support and its experimental evaluation in prolonged ECMO.

The authors developed a new membrane oxygenator (MO) for long-term respiratory support and evaluated its performance in animal experiments for as long as 336 hr. The MO, with a membrane area of 1.2 m2 and priming volume of 140 ml, is compact and designed to be interposed in a ventricular assist system (VAS) conduit. It is made with a novel hollow fiber membrane, in which micropores are blind-ended so that serum leakage can be prevented during prolonged use. The blood contacting surface of the MO is heparinized with a newly developed covalent bonding technique that ensures good thrombus resistance. In vivo evaluation with five adult goats was performed by installing the MO into a venoarterial or venovenous bypass circuit. No systemic anticoagulant therapy was used, except for a heparin-added fluid infusion to keep the pressure monitoring lines open (2-3 U/kg/hr). Throughout the experiments, no plasma leakage was observed, and gas transfer rates were maintained in a satisfactory range. Platelet counts did not decrease to less than 60% of levels before bypass, and hemolysis was negligible. The levels of coagulation parameters including fibrinogen, fibrin degradation products (FDP), antithrombin III (AT III), antiplasmin, prothrombin time (PT) and activated partial thromboplastic time (APTT) remained within physiologic ranges and relatively constant. At the end of the evaluation, no thrombus formation was noted in three of five MOs. These results suggest that this MO is a promising device for long-term respiratory support.

Animals↗

PubMedDate not supplied

Altered oxygen metabolic conditions associated with increased norepinephrine levels in a nonpulsatile systemic circulation.

Change in oxygen metabolic conditions accompanying the conversion of systemic flow from pulsatile to nonpulsatile (from P-mode to N-mode) was investigated in association with blood norepinephrine levels. Total left heart bypass was instituted through a left thoracotomy under general anesthesia in 10 adult goats. Pulsatile and nonpulsatile pumps were incorporated in the circuit in parallel, and the flow character was rapidly converted from the P-mode to the N-mode. Norepinephrine levels increased significantly after the conversion, from 222 +/- 54 pg/ml to 285 +/- 65 pg/ml. While oxygen delivery (DO2) was kept constant, the oxygen extraction ratio significantly decreased, from 21 +/- 3% to 16 +/- 3%, and venous oxygen saturation (SvO2) significantly increased, from 77 +/- 6% to 84 +/- 6% after depulsation. The serum lactate level was significantly higher in the N-mode than the P-mode (P-mode: 35 +/- 2 mg/dl, N-mode: 45 +/- 5 mg/dl). Strong positive and negative correlations of norepinephrine levels were observed with oxygen extraction ratio and SvO2, respectively, whereas norepinephrine levels did not correlated with DO2. Regression lines in these correlations unveiled higher oxygen uptake in the P-mode than the N-mode at the same norepinephrine level. These results indicate that, in the setting of an acute animal experiment, oxygen uptake is less efficient with the absence of pulsatility, and the higher norepinephrine concentration functioned to tune the oxygen metabolism in the initial stage of nonpulsatile systemic circulation.

Animals↗

PubMedDate not supplied

Characterization and optimization of the flow pattern inside a diaphragm blood pump based on flow visualization techniques.

We applied two different flow visualization techniques to obtain detailed information on the inside flow of the diaphragm blood pump of our electrohydraulic total artificial heart system to determine the optimum washout effect that would result in better antithrombogenicity. Major orifice directions of the inflow and outflow Bjork-Shiley valves of the left blood pump were independently changed to create 17 varied patterns. The character and velocity of the main flow at the diaphragm-housing junction were acquired using a laser light sheet method with polyethylene tracers. Wall shear flow, a major factor governing washout in the blood pump, was estimated by a newly developed paint erosion method. In this method, quantitative evaluation for an index of washout effect was made by calculating the residual ratio of the paint on the blood pump inner surface at 30 sec of pumping. When a single circular flow was consistently observed by the laser light sheet method, the paint residual ratio become low, indicating washout was relatively good. At the lowest paint residual ratio, the center of the circular flow observed by the laser light sheet method was located at the geometric center of the blood chamber. In conclusion, the flow pattern inside the blood pump could be characterized by combined use of these two flow visualization techniques, and the significant role of circular flow in better washout was clarified.

Heart, Artificial↗

PubMedDate not supplied

Transcutaneous optical telemetry system with infrared laser diode.

A transcutaneous telemetry system is indispensable when monitoring and controlling the operation of an artificial heart totally implanted inside the body. A telemetry system using light is more useful than radio waves from the viewpoint of electromagnetic interference and power consumption. In this report, a transcutaneous optical coupler consisting of an infrared laser diode (LD) and a PIN photodiode (PINPD) was evaluated, and the transcutaneous optical coupling and information transmission characteristics were evaluated in in vitro experiments. The wavelength and directional angle of the LD used were 830 nm and 9.5 degrees, respectively. With regard to the directional angle of PINPD, the authors found that a PINPD with a larger directional angle allowed for more deviation between the axes optical axes of the LD and the PINPD. It was also found that the transcutaneous coupler had an optimum distance for the permissible deviation to be maximized. The information signals modulated by the phase shift keying (PSK) were transmitted at a rate of 9,600 bps through goat skin 4 mm thick, and demodulated by the phase locked loop (PLL) on the receiving side. As a result, the information signals were demodulated without any errors in deviation within 10.5 mm at a distance of 11 mm. In conclusion, the transcutaneous optical telemetry system using an infrared LD has sufficient characteristics to monitor and control the operation of an artificial heart totally implanted inside the body.

Heart, Artificial↗

PubMedDate not supplied

Hemodynamic effects of prostaglandins and catecholamines in graded reduction of pulmonary flow during venoarterial bypass in awake goats.

The roles of prostaglandins and catecholamines in the hypotensive hemodynamic change during cardiopulmonary support with a venoarterial bypass (VAB) were investigated in a series of chronic animal experiments of gradually reduced pulmonary arterial blood flow (PAF). The VAB system consisted of a pulsatile ventricular assist device, an artificial lung, and the right atrium uptake and descending aorta return cannulae in four adult goats weighing 49-51 kg. The PAF was adjusted to 50, 10, and 0% of the total systemic blood flow. Indomethacin, an inhibitor of prostaglandin production; phentolamine, an alpha-antagonist of catecholamine; and noradrenaline, an agonist of catecholamine were administered at each PAF condition. The mean aortic pressure (mAoP) and the systemic vascular resistance decreased in proportion to the decrease in PAF. Indomethacin increased the mAoP at all PAF conditions, indicating a relationship between prostaglandins and hypotension. Phentolamine decreased the mAoP at all PAF conditions, indicating a normal response of catecholamine receptors. However, noradrenaline increased the mAoP at 50 and 10% PAF, but did not appreciably increase the value at 0% PAF, indicating complete response of catecholamine receptors to endogenous catecholamines at 0% PAF only. In conclusion, prostaglandins play a substantial role in hypotension during VAB, and catecholamines may subsequently increase in compensation for extreme hypotension.

Adrenergic alpha-Agonists↗

PubMedDate not supplied

Selection of a rechargeable internal back-up battery for a totally implantable artificial heart.

Three kinds of rechargeable batteries, NiCd, NiMH, and Li+, were compared for the purpose of selecting the most appropriate battery for use in a Rechargeable Internal Back-up Battery (RIBB) unit for a Totally Implantable Artificial Heart. Batteries of each kind were connected in series to obtain the required driving voltage of 24 V. The NiCd and NiMH batteries were charged by a constant current of 1 C, and the Li+ batteries were charged first by a constant current of 1 C and later by a constant voltage of 28.7 V. All three types of batteries were discharged using a dummy electronic pulsatile load consuming 20 W of power. The tests showed that the Li+ batteries were capable of supplying the required energy for more than 60 minutes. The Li+ batteries had a specific energy of 121.5 Wh/kg, which was more than 3x that of the NiCd and NiMH, and an energy density of 282.5 Wh/L more than double that of the other two. In addition, the Li+ batteries recorded the least temperature rise during charging and discharging. The results of our tests conclusively showed that the Li+ battery is the best among the three for use in an RIBB from the viewpoint of energy density and temperature rise.

Electricity↗

PubMedDate not supplied

Effects of long-term nonpulsatile left heart bypass on the mechanical properties of the aortic wall.

We investigated the mechanical properties of the descending aortic wall relative to its structural change caused by reduced pulse pressure in long-term nonpulsatile left heart bypass (LHB). Fifteen adult goats (53-68 kg) were divided into three groups: five goats underwent LHB with a nonpulsatile pump for 31 to 381 days (Group N), five goats underwent LHB with a pulsatile pump for 24 to 130 days (Group P), and the other five goats were used as normal control animals (Group C). The aortic pulse wave pressure was 17+/-7 mm Hg in Group N, 43+/-1 mm Hg in Group P, and 39+/-2 mm Hg in Group C. Structural changes were evaluated using wall thickness and the volume ratio of elastin and collagen. The mechanical properties were evaluated using "beta," which was calculated according to the equation: = (In P/Ps)/(Do/Ds-1), where Ps was the standard pressure, Ds was the wall diameter at pressure Ps, and Do was the wall diameter at pressure P. The wall thickness of the aortic wall in Group N (1.6+/-0.3 mm) was significantly thinner than that in either Group P (2.2+/-0.3 mm) or Group C (2.1+/-0.2 mm). The volume ratio of elastin in Group N (51 +/- 3%) was higher than that in Group P (44+/-1%) or Group C (40+/-1%), whereas no significant difference was found in the volume ratio of collagen between those in Group N (10+/-1%), Group P (9+/-2%), and Group C (10+/-1%). The stiffness parameter, beta, in Group N (3.1+/-0.7) was slightly higher than that seen in Group P (2.9+/-0.4) or Group C (2.9+/-0.2), but there was no significant difference between the three groups. These results indicate that long-term nonpulsatile LHB caused marked structural changes in the aortic wall, whereas the change in mechanical properties were not significant with regard to stiffness.

Animals↗

PubMedDate not supplied

Control of a total artificial heart using mixed venous oxygen saturation.

We developed a control of the total artificial heart (TAH) using mixed venous oxygen saturation (SvO2). With this method, the TAH output was controlled by automatically adjusting drive parameters in response to changes in measured SvO2. The feasibility and validity of this method were evaluated in a series of treadmill exercise tests using a calf implanted with a pneumatic TAH. The cardiac output (CO) and SvO2 were measured with an ultrasonic flowmeter and an oximetric catheter, respectively. The calf performed graded exercise under a fixed drive control mode (fixed mode), in which the drive parameters were unchanged throughout the treadmill test, and under the SvO2 based control mode (SvO2 mode). The calf could go to Stage 6 in both modes, but the maximal oxygen consumption in the SvO2 mode was 1.5 times as large as that of the fixed mode. Compared with the fixed mode, CO was increased effectively in the SvO2 mode, and the capacity for exercise was augmented. When considering the relationship between oxygen consumption and oxygen delivery, it was revealed that the CO in the SvO2 mode responded more adequately to the recipient's oxygen demand than that in the fixed mode. We conclude that this SvO2 based control method is feasible and physiologically effective.

Animals↗

PubMedDate not supplied

A transcutaneous energy transmission system with rechargeable internal back-up battery for a totally implantable total artificial heart.

We have been developing an externally coupled transcutaneous energy transmission system (ECTETS) for a totally implantable total artificial heart (TITAH). When the ECTETS is unable to supply the energy to drive the TITAH from outside the body, a rechargeable internal back-up battery (RIBB) implanted inside the body is used as a back-up to supply the required energy. This paper reports on the performance characteristics of our ECTETS with an RIBB. In this study, a lithium-ion (Li+) secondary battery was used as the RIBB. The transcutaneous energy transmission and the charging control characteristics of the ECTETS, while simultaneously supplying energy to the TITAH and the RIBB, were evaluated in an in vitro experiment. The output power and transmission efficiency of the ECTETS operating in this mode were found to vary from 20 W to 34 W and from 84% to 71%, respectively. It was also found that a sufficient power of more than 20 W could be supplied to the TITAH. The time needed to fully charge the RIBB was 117 minutes, and a fully charged RIBB could drive the TITAH, consuming 20 W for 62 minutes. It may, therefore, reasonably be concluded that the ECTETS with the RIBB is sufficient to drive the TITAH.

Animals↗

PubMedDate not supplied

Progress of an electrohydraulic total artificial heart system with a separate energy converter.

We have been developing an electrohydraulic total artificial heart (EHTAH) system. The system consists of diaphragm blood pumps, an abdominally placed energy converter, an internal controller, a transcutaneous energy transfer (TET) system, a transcutaneous optical information transfer system, and internal and external lithium-ion (Li-ion) batteries. The energy converter was optimized to obtain better oil transfer. Maximum cardiac output and efficiency of the EHTAH were increased from 8 L/min to 10 L/min and from 10% to 12%, respectively. The volume of the energy converter was reduced from 280 to 210 ml. The pumping unit was successfully implanted in 68-85 kg calves without anatomic problems, and the calves survived up to 10 days with good circulatory results. The maximum temperature rise of the implanted energy converter was only 1 degrees C. Stable performance of the TET system was confirmed in goats for more than 1 month. DC-DC energy transfer efficiency with 20 W of energy transmission remained within the range of 80% to 85%, and no significant temperature rise was observed in the implanted circuit. The internal Li-ion battery was also evaluated in a goat, and the maximum temperature rise during the charging period was 1.5 degrees C, while the charging and discharging times were 72 and 58 min, respectively. We conclude that our system has progressed in its development as a practical implantable system.

Animals↗

PubMedDate not supplied

Influence of pulsatile and nonpulsatile left heart bypass on the hormonal circadian rhythm.

We investigated endocrine circadian rhythm (CR) during pulsatile and nonpulsatile left heart bypass (PLHB and NLHB). A ventricular assist device (VAD) was installed in five goats. After 2 weeks of PLHB, NLHB was subsequently conducted for 4 weeks. The levels of melatonin, cortisol, and renin activity were measured every 2 hours for 24 hours on the last day of the second PLHB week and the second and fourth NLHB weeks. Acquired data were compared with those of the normal control goats (Cont) to determine the presence or absence of CR, as well as the timing, acrophase, amplitude, and mesor of CR. Variations in melatonin, CR were consistently detected at all sampling points. In contrast, CR of cortisol during PLHB and NLHB was observed in a few cases, although considerable CR was noted in most of the Cont cases. The variations in renin activity indicated CR in most of the Cont cases and in all cases at all sampling points during PLHB and NLHB, whereas their acrophases were diversified. In conclusion, the CR of melatonin, reflecting the fundamental circadian clock, was maintained during both PLHB and NLHB, while it could be modified for stress sensitive cortisol and hemodynamic responsive renin during these bypass modalities.

Animals↗

PubMedDate not supplied

Noninvasive assessment method to determine the anatomic compatibility of an implantable artificial heart system.

To assess the anatomic compatibility of an artificial heart (AH), we attempted to develop a computer environment that would facilitate a reliable simulation of an AH implanted in the human thorax. A three-dimensional thoracic computer model with a ventricle-resected heart was constructed, by using manually extracted contour points of the aorta, pulmonary artery, atria, atrioventricular valves, diaphragm, and thoracic wall from a set of consecutive CT images. Such a model enabled simulation of an AH implantation by orienting the AH model in it. Error evaluation on CT imaging and contour extraction with a Plexiglas cylindrical phantom showed that the diameter of the extracted phantom contour was approximately 2 mm smaller than its original with a standard deviation of <0.5 mm. Errors in contour and surface reconstruction could be reduced to far less than 1 mm under constrained conditions. A study on the influence of breathing revealed that variations in some thoracic dimensions between inspiration and expiration could reach 10 mm. In summary, computer simulation of AH implantation is a worthwhile approach with acceptable accuracy, although further considerations of extreme thoracic situations will be required.

Computer Simulation↗

PubMedDate not supplied

Mixed venous oxygen saturation as a promising parameter for physiologic control of total artificial heart.

Mixed venous oxygen saturation (SvO2) has been proposed as one of the suitable parameters for physiologic control of a total artificial heart (TAH). To establish the practical application of SvO2, we investigated the response of cardiac output (CO) and SvO2 to step-loaded exercise. A normal calf was surgically equipped with an ultrasonic flowmeter probe and an oximetry catheter in the pulmonary artery to measure CO and SvO2, respectively. Three stage step treadmill exercise tests (1, 2, and 4 km/h) were performed three times. While CO increased from 8.9 L/min at preexercise level to 9.7, 10.2 and 11.4 L/min at 1, 2, and 4 km/h, respectively, SvO2 decreased from 59.6% to 56.8, 55.3, and 52.2%, respectively. There existed a linear correlation between the magnitude of changes in CO and SvO2. CO and SvO2 exhibited a similar course of change, expressing an inverted exponential curve. The time constant of SvO2 was from 19 to 35 seconds, whereas that of CO was from 21 to 39 seconds. We conclude that SvO2 changes in close association with CO during exercise and has good potential to be a parameter for physiologic control of a TAH, by reflecting the recipient's CO demand without conspicuous time delay.

Animals↗

PubMedDate not supplied

Performance of a newly developed implantable centrifugal blood pump.

The performance of the newly developed implantable centrifugal blood pump was investigated in vitro. The pump was developed with the end goal of building a versatile system that includes a left ventricular assist system with an internal secondary battery or an implantable biventricular assist system with two implantable blood pumps. The hydrodynamic characteristics and efficiency of the blood pump were evaluated, and the mechanical damage to the blood caused by the blood pump was assessed through a hemolysis test using fresh goat blood. The pump could generate 120 mm Hg at a flow rate of 5 L/min and a motor speed of 2,500 rpm. The electric input power to the pump was approximately 5 watts under these working conditions. The hemolysis caused by the pump was a bit higher than that by the former model, but stayed within an acceptable range. Performance of the pump in vitro was considered sufficient for a left ventricular assist device, although further design improvement is necessary in terms of hemolysis and system efficiency to improve biocompatibility of the pump.

Animals↗

PubMedDate not supplied

Prostaglandin synthesis inhibitor improves hypotension during normothermic cardiopulmonary bypass.

Hypotension is a major systemic side effect during cardiopu monary bypass (CPB), especially at normothermia. We previously reported that prostaglandin (PG) might play a substantial role in hypotension. The purpose of this study was to clarify whether a PG synthesis inhibitor (PGSI) could improve hypotension during CPB. Thirty-six patients undergoing cardiac surgery with normothermic CPB (35-37 degrees C) were divided into two groups: a PGSI group (n = 18), whose members wer given a PGSI before and during CPB, and a control group (n = 18). In both groups, perfusion flow was sufficient and pressure was maintained at above 45 mm Hg by infusion of metaraminol, a vasoconstrictor. The mean arterial pressure throughout CPB was significantly higher in the PGSI group than in the control group (57 +/- 4 vs. 48 +/- 3 mm Hg, p < 0.01), whereas the dose of infused metaraminol was significantly lower in the PGSI group (13 +/- 7 vs. 21 +/- 6 mg, p < 0.01). The blood base excess was not significantly different (1.0 +/- 1.6 vs. 1.7 +/- 1.9 mmol/L, p = 0.28), and urine output was significantly higher in the PGSI group (503 +/- 179 vs. 354 +/- 112 ml/hr, p < 0.01). In conclusion, PGSI can improve hypotension during CPB and increase urine output without impairing peripheral circulation.

Aged↗