CARDIOVASCULAR ENGINEERING Journal for Extracorporeal Circulation, Assist Devices,Transplantation and Artificial Organs
	Volume 2, 1997, No 4

Extended Monitoring of Heart-, Lung-, and Liver-Performance During Mechanical Circulatory Support by the Novacor-System

O. Gödje, W. Roell, Ch. Schmitz, O. Dewald, H. O. Vetter, B. Reichart

Abstract:
Background: The Novacor left ventricular assist system has proved to be a reliable and safe method for bridging to cardiac transplantation. We tested a new device for the measurement of hemodynamics, blood volume compartments, lung water and liver function on its use in monitoring mechanically supported patients at the ICU. Methods: In nine patients (mean age 34.9 years), the wearable Novacor system N100 was implanted. Preoperatively, during the first postoperative week and before heart transplantation right and left ventricular cardiac output, right ventricular ejection fraction, pulmonary-, intrathoracic- and total blood volume, extravascular lung water and excretory liver function were monitored by means of double indicator dilution technique with the COLD system. Results: During left ventricular assistance, both pulmonary and systemic arterial cardiac outputs increased significantly (students t-test, p <0.05). right ventricular ejection fraction rose from 17 to 29%, preoperatively elevated pulmonary- and intrathoracic blood volumes and extravascular lung water fell significantly to normal ranges. total blood volume remained constant, excretory liver function improved markedly. conclusions: pulmonary cardiac output improves due to the reduced right ventricular afterload by unloading the impaired left ventricle with the novacor pump. the drop in pulmonary blood volume, intrathoracic blood volume and extravascular lung water also indicates a decrease of pulmonary congestion. since total blood volume remains unchanged, a volume shift to systemic circulation is suggested, resulting in an improved splanchnic perfusion as demonstrated by a better excretory liver function. the additional information about the volume status and the organ function given by the cold system are useful for the management of mechanically supported patients.

Keywords:
Novacor, left ventricular assist device, COLD-system, bridge-to-transplantation

Address for Correspondence:

Reference:
(CVE. 1997; 2 (4): 244-249)

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