Design and Evaluation of the Afari: A Three-wheeled Mobility and Balance Support Device for Outdoor Exercise

2021 ◽  
Author(s):  
Mohsen Alizadeh Noghani ◽  
Drew Browning ◽  
Vincent Caccese ◽  
Elizabeth DePoy ◽  
Stephen Gilson ◽  
...  
Keyword(s):  
Support Device ◽  
Wheeled Mobility

scholarly journals Inhaled nitric oxide preserves ventricular function during resuscitation using a percutaneous mechanical circulatory support device in a porcine cardiac arrest model: an echocardiographic myocardial work analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Christoph Nix ◽  
Rashad Zayat ◽  
Andreas Ebeling ◽  
Andreas Goetzenich ◽  
Uma Chandrasekaran ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Cardiac Arrest ◽  
Mechanical Circulatory Support ◽  
Left Ventricular ◽  
Inhaled Nitric Oxide ◽  
Circulatory Support ◽  
Support Device ◽  
Mechanical Circulatory Support Device ◽  
Rv Function ◽  
Circulatory Support Device

Abstract Background Resuscitation using a percutaneous mechanical circulatory support device (iCPR) improves survival after cardiac arrest (CA). We hypothesized that the addition of inhaled nitric oxide (iNO) during iCPR might prove synergistic, leading to improved myocardial performance due to lowering of right ventricular (RV) afterload, left ventricular (LV) preload, and myocardial energetics. This study aimed to characterize the changes in LV and RV function and global myocardial work indices (GWI) following iCPR, both with and without iNO, using 2-D transesophageal echocardiography (TEE) and GWI evaluation as a novel non-invasive measurement. Methods In 10 pigs, iCPR was initiated following electrically-induced CA and 10 min of untreated ventricular fibrillation (VF). Pigs were randomized to either 20 ppm (20 ppm, n = 5) or 0 ppm (0 ppm, n = 5) of iNO in addition to therapeutic hypothermia for 5 h following ROSC. All animals received TEE at five pre-specified time-points and invasive hemodynamic monitoring. Results LV end-diastolic volume (LVEDV) increased significantly in both groups following CA. iCPR alone led to significant LV unloading at 5 h post-ROSC with LVEDV values reaching baseline values in both groups (20 ppm: 68.2 ± 2.7 vs. 70.8 ± 6.1 mL, p = 0.486; 0 ppm: 70.8 ± 1.3 vs. 72.3 ± 4.2 mL, p = 0.813, respectively). LV global longitudinal strain (GLS) increased in both groups following CA. LV-GLS recovered significantly better in the 20 ppm group at 5 h post-ROSC (20 ppm: − 18 ± 3% vs. 0 ppm: − 13 ± 2%, p = 0.025). LV-GWI decreased in both groups after CA with no difference between the groups. Within 0 ppm group, LV-GWI decreased significantly at 5 h post-ROSC compared to baseline (1,125 ± 214 vs. 1,835 ± 305 mmHg%, p = 0.011). RV-GWI was higher in the 20 ppm group at 3 h and 5 h post-ROSC (20 ppm: 189 ± 43 vs. 0 ppm: 108 ± 22 mmHg%, p = 0.049 and 20 ppm: 261 ± 54 vs. 0 ppm: 152 ± 42 mmHg%, p = 0.041). The blood flow calculated by the Impella controller following iCPR initiation correlated well with the pulsed-wave Doppler (PWD) derived pulmonary flow (PWD vs. controller: 1.8 ± 0.2 vs. 1.9 ± 0.2L/min, r = 0.85, p = 0.012). Conclusions iCPR after CA provided sufficient unloading and preservation of the LV systolic function by improving LV-GWI recovery. The addition of iNO to iCPR enabled better preservation of the RV-function as determined by better RV-GWI. Additionally, Impella-derived flow provided an accurate measure of total flow during iCPR.

scholarly journals Therapeutic approach for global myocardial injury using bone marrow-derived mesenchymal stem cells by cardiac support device in rats

2021 ◽  
Vol 23 (1) ◽  
Author(s):  
Ziwei Liu ◽  
Muhammad Naveed ◽  
Mirza Muhammad Faran Ashraf Baig ◽  
Reyaj Mikrani ◽  
Cuican Li ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Mesenchymal Stem Cells ◽  
Therapeutic Approach ◽  
Myocardial Injury ◽  
Support Device ◽  
Cardiac Support Device

scholarly journals Contrast‐enhanced ultrasound imaging can be used to evaluate fetal cerebral perfusion: potential implications for fetal surgery

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Kendall M. Lawrence ◽  
Barbara E. Coons ◽  
Anush Sridharan ◽  
Avery C. Rossidis ◽  
Marcus G. Davey ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Cerebral Perfusion ◽  
Fetal Surgery ◽  
Time Dependent ◽  
Contrast Enhanced Ultrasound ◽  
Acid Base ◽  
Fetal Sheep ◽  
Contrast Enhanced ◽  
Support Device ◽  
Acid Base Status

Abstract Background Fetal surgery is increasingly performed to correct congenital defects. Currently, fetal brain perfusion cannot be assessed intra-operatively. The purpose of this study was to determine if contrast-enhanced ultrasound (CEUS) could be used to monitor fetal cerebral perfusion during fetal surgery and if parameters correlate with fetal hemodynamics or acid/base status. Methods Cannulated fetal sheep were insufflated with carbon dioxide gas in an extra-uterine support device and in utero to mimic fetal surgery. Fetal heart rate, mean arterial pressure, and arterial blood gases were serially measured. CEUS examinations of the brain were performed and time-dependent metrics were quantified to evaluate perfusion. The relationships between measured parameters were determined with mixed linear effects models or two-way repeated measures analysis of variance. Results 6 fetal sheep (113 ± 5 days) insufflated at multiple time-points (n = 20 experiments) in an extra-uterine support device demonstrated significant correlations between time-dependent perfusion parameters and fetal pH and carbon dioxide levels. In utero, 4 insufflated fetuses (105 ± 1 days) developed hypercarbic acidosis and had reductions in cerebral perfusion parameters compared to age-matched controls (n = 3). There was no significant relationship between cerebral perfusion parameters and fetal hemodynamics. Conclusions CEUS-derived cerebral perfusion parameters can be measured during simulated fetal surgery and strongly correlate with fetal acid/base status.

A simulation tool for mechanical circulatory support device interaction with diseased states

2020 ◽  
Vol 23 (2) ◽  
pp. 124-132
Author(s):  
David J. Horvath ◽  
Dennis W. Horvath ◽  
Jamshid H. Karimov ◽  
Barry D. Kuban ◽  
Takuma Miyamoto ◽  
...  
Keyword(s):  
Mechanical Circulatory Support ◽  
Circulatory Support ◽  
Simulation Tool ◽  
Support Device ◽  
Mechanical Circulatory Support Device ◽  
Device Interaction ◽  
Circulatory Support Device
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