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Numerical and Experimental Investigation of a Lighthouse Tip Drainage Cannula Used in Extracorporeal Membrane Oxygenation

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Journal Artif Organs
Date 2022 Oct 13
PMID 36227654
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Abstract

Background: Extracorporeal membrane oxygenation is a life-saving therapy used in case of acute respiratory/circulatory failure. Exposure of blood to non-physiological surfaces and high shear stresses is related to hemolytic damage and platelet activation. A detailed knowledge of the fluid dynamics of the components under different scenarios is thus paramount to assess the thrombogenicity of the circuit.

Methods: An investigation of the flow structures developing in a conventional lighthouse tip (single-staged) drainage cannula was performed with cross-validated computational fluid dynamics and particle image velocimetry. The aim was to quantify the variation in drainage performance and stress levels induced by different fluid models, hematocrit and vessel-to-cannula flow rate ratios.

Results: The results showed that the 90° bends of the flow through the side holes created a recirculation zone inside the cannula which increased residence time. Flow structures resembling a jet in a crossflow were also observed. The use of different hematocrits did not significantly affect drainage performances. The most proximal set of holes drained the largest fraction of fluid. However, different flow rate ratios altered the flow rate drained through the tip. The use of 2D data led to a 50% underestimation of shear rate levels. In the drainage zone the non-Newtonian behavior of blood was less relevant.

Conclusions: The most proximal holes drained the largest amount of fluid. The flow features and distribution of flow rates among the holes showed little dependence on the hematocrit. The non-Newtonian behavior of blood had a small influence on the dynamics of the flow.

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References
1.
Broman L, Prahl Wittberg L, Westlund C, Gilbers M, Perry da Camara L, Westin J . Pressure and flow properties of cannulae for extracorporeal membrane oxygenation II: drainage (venous) cannulae. Perfusion. 2019; 34(1_suppl):65-73. DOI: 10.1177/0267659119830514. View

2.
Andersson Lindholm J . Cannulation for veno-venous extracorporeal membrane oxygenation. J Thorac Dis. 2018; 10(Suppl 5):S606-S612. PMC: 5911563. DOI: 10.21037/jtd.2018.03.101. View

3.
Iacobelli R, Fletcher-Sandersjoo A, Lindblad C, Keselman B, Thelin E, Broman L . Predictors of brain infarction in adult patients on extracorporeal membrane oxygenation: an observational cohort study. Sci Rep. 2021; 11(1):3809. PMC: 7884423. DOI: 10.1038/s41598-021-83157-5. View

4.
Di Nardo M, Hoskote A, Thiruchelvam T, Lillie J, Horan M, Belda Hofheinz S . Extracorporeal Membrane Oxygenation in Children with Coronavirus Disease 2019: Preliminary Report from the Collaborative European Chapter of the Extracorporeal Life Support Organization Prospective Survey. ASAIO J. 2020; 67(2):121-124. PMC: 7846251. DOI: 10.1097/MAT.0000000000001309. View

5.
Litwak K, Unger L, Fukamachi K, Saeed D . Retrospective analysis of adverse events in preclinical ventricular assist device experiments. ASAIO J. 2008; 54(4):347-50. DOI: 10.1097/MAT.0b013e31817d92a8. View