A new cardiopulmonary bypass operating system permitting regulation by the surgeon in the operation field

Abstract

For safer and easier management of the cardiop-ulmonary bypass (CPB) system, we have developed a new CPB operating system with which a surgeon in the operation field can also control CPB flow by manipulating venous line. With the insertion of a pressure-sensitive flow pump regulator into the conventional closed-circuit CPB system, a surgeon in the operation field can precisely control CPB flow by clamping a venous line to various degrees. In this regulator, two pressure sensors are attached both in front of and behind the flow control roller pump, which allows regulation of bypass flow in case of inadvertent total clamping of an arterial line. Additionally, by attaching a level sensed on-off switch of a volume control pump to a blood reservoir chamber, semiautomated regulation of blood reservoir volume is feasible. A clinical trial of five cases with this system revealed that our control system provided safe and effective flow control in both the initiating and the discontinuing phases of CPB with the surgeon's manipulation. Moreover, throughout CBP, the blood reservoir volume was easily controlled only by changing the position of the level sensor, which reduced the perfusionist's task of operating the volume and suction control roller pump. In conclusion, our system can provide not only a fail-safe system against abrupt kinking of the bloodstream line, but also reduction of the perfusionists' burden during CPB management.