• Journal of Chest Surgery
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• v.40 no.7 s.276
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• pp.512-516
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• 2007

A mechanical circulatory support system is a life-saving option for treating acute severe respiratory failure or cardiac failure. There are currently a few types of assist devices and the Twin-Pulse Life Support (T-PLS) system is a kind of pulsatile pump. We report here on three patients with severe life threatening cardiopulmonary dysfunction who had the T-PLS system used as an assist device. The indications for applying the T-PLS system were continuing respiratory or cardiac failure in spite of maximal ventilatory and inotropic support. There were two patients with acute respiratory failure due to infection and one patient with cardiac failure due to acute myocarditis. One respiratory failure patient and one cardiac failure patient survived after applying the T-PLS system for 3 days and 5 days, respectively. The T-PLS system is useful as an assist device and it should be considered before multi-organ failure occurs.

• Journal of The Korean Society of Clinical Toxicology
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• v.2 no.2
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• pp.133-136
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• 2004

Phalloides syndrome has usually occurred after incidental mushroom ingestion. It is sometimes difficult to differentiate toxic mushrooms from edible ones, especially in lay person because of their morphological similarities. In Korea, Amanita virosa and Amanita subjunquillea have been reported as a cause of fulminant hepatic failure in mushroom poisoning (phalloides syndrome). We report a case of phalloides syndrome who came to death with fulminant hepatic failure even though we planned liver transplantation and used T-PLS(R) (Twin Pulse Life Support) for hemodynamic support while waiting for the donor.

• Proceedings of the KSME Conference
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• 2008.11a
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• pp.1679-1682
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• 2008

Pulsatile Extracorporeal Membrane Oxygenation(ECMO) can mitigate the heart load and raise the patient's blood perfusion. But If the ECMO pulsate the blood flow during the systolic period, It can burden to the patient's heart. To avoid the heart injury, we have to consider the relation between output of ECMO, hemodynamic states and heart movement. To raise the efficacy of the pulsatile ECMO, we investigated the coronary perfusion, cardiac muscle tension and hemodynamic states during the ECMO perfusion by using the mathematical model of human blood circulatory system and ECMO. The outflow data of the pulsatile ECMO(T-PLS, Bioheartkorea, Korea) was obtained in vitro experiments. According to the phase and pumping rate of the ECMO, the heart's load and coronary perfusion could be adjusted to the proper levels. The results of the human- ECMO lumped parameter model showed that the synchronizing operation of the pulsatile ECLS can be helpful at stabilizing the patient's hemodynamic states.

• Journal of Chest Surgery
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• v.38 no.10 s.255
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• pp.661-668
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• 2005

Background: We have hypothesized that, if a low resistant gravity-flow membrane oxygenator is used, then the twin blood sacs of TPLS can be located at downstream of the membrane oxyenator, which may double the pulse rate at a given pump rate and increase the pump output. The purpose of this study was to determine the optimal configuration for the ECLS circuits by using the concept of pulse energy and pump output. Material and Method: Animals were randomly assigned to 2 groups in a total cardiopulmonary bypass model. In the serial group, a conventional membrane oxygenator was located between the twin blood sacs. In the parallel group, the twin blood sacs were placed downstream of the gravity-flow membrane oxygenator. Energy equivalent pressure (EEP) and pump output were collected at pump-setting rates of 30, 40, and 50 BPM. Result: At the given pump-setting rate, the pulse rate was doubled in the parallel group. Percent changes of mean arterial pressure to EEP were $13.0\pm1.7,\; 12.0\pm1.9\;and\;7.6\pm0.9\%$ in the parallel group, and $22.5\pm2.4,\; 23.2\pm1.9,\;and\;21.8\pm1.4\%$ in the serial group at 30, 40, and 50 BPM of pump-setting rates. Pump output was higher in the parallel circuit at 40 and 50 BPM of pump-setting rates $(3.1\pm0.2,\;3.7\pm0.2L/min\;vs.\;2.2\pm0.1\;and\;2.5\pm0.1L/min,\;respectively,\;p=0.01)$. Conclusion: Either parallel or serial circuit configuration of the ECLS generates effective pulsatility. As for the pump out, the parallel circuit configuration provides higher flow than the serial circuit configuration.

• Journal of Biomedical Engineering Research
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• v.28 no.3
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• pp.387-391
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• 2007

An oxygenator is a very important artificial organ and widely used for patients with lung failure or during open heart surgery. Although an oxygenator has been widely studied worldwide to enhance its efficiency, studies on oxygenators, in particular when using a pulsatile blood flow, are domestically limited. Therefore, a new oxygenator was developed in the lab and animal experimental results are described in the paper. The oxygenator is composed of polycarbonate housing and polypropylene hollow fibers. It has a total length of 400 mm and a surface area of $1.7 m^2$. The animal experiment lasted for 4 hours. The blood flow rate was set to 2 L/min and a pulsatile blood pump, T-PLS (Twin-Pulse Life Support), was used. Samples were drawn at the oxygenator's inlet and outlet. The total hemoglobin (Hb), saturation oxygen ($sO_2$), and partial oxygen pressure ($pO_2$), partial $CO_2$ pressure ($pCO_2$), and plasma bicarbonate ion concentration ($HCO_3^-$) were measured. The oxygen and carbon dioxide transfer rates were also calculated based on the experimental data in order to estimate the oxygenator's gas transfer efficiency. The oxygen and carbon dioxide transfer rates were $16.4{\pm}1.58$ and $165.7{\pm}10.96 mL/min$, respectively. The results showed a higher carbon dioxide transfer rate was achieved with the oxygenator. Also, the mean inlet and outlet blood pressures were 162.79 and 137.92 mmHg, respectively. The oxygenator has a low pressure drop between its inlet and outlet. The aim of own preliminary study was to make a new oxygenator and review its performance when applying a pulsatile blood pump thus, confirming the possibility of a new oxygenator suitable for pulsatile flow.

• Journal of Chest Surgery
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• v.38 no.1 s.246
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• pp.13-22
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• 2005

It has been known that pulsatile flow is physiologic and more favorable to tissue perfusion than nonpulsatile flow. The purpose of this study is to directly compare the effect of pulsatile versus nonpulsatile blood flow to renal tissue perfusion in extracorporeal circulation by using a tissue perfusion measurement system. Material and Method: Total cardiopulmonary bypass circuit was constructed to twelve Yorkshire swines, weighing 20$\~ $30 kg. Animals were randomly assigned to group 1 (n=6, non pulsatile centrifugal pump) or group 2 (n=6, pulsatile T-PLS pump). A probe of the tissue perfusion measurement system $(QFlow^{TM}-500)$ was inserted into the renal pa­renchymal tissue. Extracorporeal circulation was maintained for an hour at a pump flow of 2 L/min after aortic cross-clamping. Tissue perfusion flow of the kidney was measured at baseline (before bypass) and every 10 minutes after bypass. Serologic parameters were collected at baseline and 60 minutes after bypass. Result: Baseline parameters were not different between the groups. Renal tissue perfusion flow was substantially higher in the pulsatile group throughout the bypass (ranged 48.5$\~$ 64 in group 1 vs. 65.8$\~$88.3 mL/min/100 g in group 2, p=0.026$\~$ 0.45) The difference was significant at 30 minutes bypass $(47.5{\pm}18.3\;in\;group\;1\;vs.\;83.4{\pm}28.5$ mL/min/100 g in group 2, p=0.026). Serologic parameters including plasma free hemoglobin, blood urea nitrogen, and creatinine showed no differences between the groups at 60 minutes after bypass (p=NS). Conclusion: Pulsatile flow is more beneficial to tissue perfusion of the kidney in short-term extracorporeal circulation. Further study is suggested to observe the effects to other vital organs or long-term significance.