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Hemodynamic and rec...
Hemodynamic and recirculation performance of dual lumen cannulas for venovenous extracorporeal membrane oxygenation
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- Parker, Louis P. (författare)
- KTH,Strömningsmekanik och Teknisk Akustik
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- Svensson Marcial, Anders (författare)
- Division of Medical Imaging and Technology, Department of Clinical Science, Intervention and Technology at Karolinska Institutet, Stockholm, Sweden; Department of Radiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
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- Brismar, Torkel B. (författare)
- Karolinska Institutet
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- Broman, Lars Mikael (författare)
- Karolinska Institutet
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- Prahl Wittberg, Lisa, Docent, 1978- (författare)
- KTH,Tillämpad strömningsmekanik
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(creator_code:org_t)
- Springer Nature, 2023
- 2023
- Engelska.
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 13:1
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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http://kipublication...
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Abstract
Ämnesord
Stäng
- Venovenous extracorporeal membrane oxygenation (ECMO) can be performed with two single lumen cannulas (SLCs) or one dual-lumen cannula (DLC) where low recirculation fraction (Rf) is a key performance criterion. DLCs are widely believed to have lower Rf , though these have not been directly compared. Similarly, correct positioning is considered critical although its impact is unclear. We aimed to compare two common bi-caval DLC designs and quantify R f in several positions. Two different commercially available DLCs were sectioned, measured, reconstructed, scaled to 27Fr and simulated in our previously published patient-averaged computational model of the right atrium (RA) and venae cavae at 2–6 L/min. One DLC was then used to simulate ± 30° and ± 60° rotation and ± 4 cm insertion depth. Both designs had low Rf (< 7%) and similar SVC/IVC drainage fractions and pressure drops. Both cannula reinfusion ports created a high-velocity jet and high shear stresses in the cannula (> 413 Pa) and RA (> 52 Pa) even at low flow rates. Caval pressures were abnormally high (16.2–23.9 mmHg) at low flow rates. Rotation did not significantly impact Rf . Short insertion depth increased Rf (> 31%) for all flow rates whilst long insertion only increased Rf at 6 L/min (24%). Our results show that DLCs have lower Rf compared to SLCs at moderate-high flow rates (> 4 L/min), but high shear stresses. Obstruction from DLCs increases caval pressures at low flow rates, a potential reason for increased intracranial hemorrhages. Cannula rotation does not impact Rf though correct insertion depth is critical.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Hälsovetenskap (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Health Sciences (hsv//eng)
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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