Efficacy of the Pulse Pressure Generator during Cardiopulmonary Bypass Training Using the Extracorporeal Circulation Simulator

Abstract

Objective: Cardiopulmonary bypass during cardiac surgery is an essential procedure, and the perfusionist needs to have sufficient education and training. Simulation training is suitable in such cases. We have developed a simulation system for cardiopulmonary bypass training (extracorporeal circulation simulator [ECCSIM]) and reported its efficacy. ECCSIM had no pulse pressure generator, so some perfusionists have mentioned that the operational feeling during training differs from that in real clinical cases.

In this study, we have developed a new pulse pressure generator and examined the efficacy of this system during cardiopulmonary bypass training using ECCSIM.

Materials and Methods: Results were observed as wave patterns during simulation of extracorporeal circulation with and without pulse pressure flow. Operational feeling during training of extracorporeal circulation was compared using a questionnaire survey, based on the Japanese version of the NASA Task Load Index (NASA-TLX), a subjective index, completed by seven perfusionists.

Results: With the addition of pulse pressure flow, fluctuation of arterial flow at low speed with the centrifugal pump increased, and operation of extracorporeal circulation became unstable. The questionnaire survey, including ‘Operational feeling of centrifugal pump’, ‘Feeling of afterload’, and ‘Display of pressure monitor’, showed results similar to that of the clinical situation using pulse pressure flow. The difficulty of simulator operation in extracorporeal circulation was significantly greater in the group with pulse pressure flow. Mental/physical load examined with NASA-TLX increased with pulse pressure flow.

Conclusion: Using a new pulse pressure generator with ECCSIM was effective in extracorporeal circulation training.