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In silico parametri...
In silico parametric analysis of femoro-jugular venovenous ECMO and return cannula dynamics : In silico analysis of femoro-jugular VV ECMO
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- Parker, Louis P. (författare)
- KTH,Strömningsmekanik och Teknisk Akustik,Linné Flow Center, FLOW
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- Svensson Marcial, Anders (författare)
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Division of Medical Imaging and Technology, Stockholm, Sweden; cDepartment of Radiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
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- Brismar, Torkel B. (författare)
- Department of Clinical Science, Intervention and Technology, Karolinska Institute, Division of Medical Imaging and Technology, Stockholm, Sweden; cDepartment of Radiology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
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- Broman, Lars Mikael (författare)
- ECMO Centre Karolinska, Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden; eDepartment of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden
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- Prahl Wittberg, Lisa, Docent, 1978- (författare)
- KTH,Tillämpad strömningsmekanik,Linné Flow Center, FLOW
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(creator_code:org_t)
- Elsevier BV, 2024
- 2024
- Engelska.
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Ingår i: Medical Engineering and Physics. - : Elsevier BV. - 1350-4533 .- 1873-4030. ; 125
- 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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Abstract
Ämnesord
Stäng
- Background: : Increasingly, computational fluid dynamics (CFD) is helping explore the impact of variables like: cannula design/size/position/flow rate and patient physiology on venovenous (VV) extracorporeal membrane oxygenation (ECMO). Here we use a CFD model to determine what role cardiac output (CO) plays and to analyse return cannula dynamics. Methods: : Using a patient-averaged model of the right atrium and venae cava, we virtually inserted a 19Fr return cannula and a 25Fr drainage cannula. Running large eddy simulations, we assessed cardiac output at: 3.5–6.5 L/min and ECMO flow rate at: 2–6 L/min. We analysed recirculation fraction (Rf), time-averaged wall shear stress (TAWSS), pressure, velocity, and turbulent kinetic energy (TKE) and extracorporeal flow fraction (EFF = ECMO flow rate/CO). Results: : Increased ECMO flow rate and decreased CO (high EFF) led to increased Rf (R = 0.98, log fit). Negative pressures developed in the venae cavae at low CO and high ECMO flow (high CR). Mean return cannula TAWSS was >10 Pa for all ECMO flow rates, with majority of the flow exiting the tip (94.0–95.8 %). Conclusions: : Our results underpin the strong impact of CO on VV ECMO. A simple metric like EFF, once supported by clinical data, might help predict Rf for a patient at a given ECMO flow rate. The return cannula imparts high shear stresses on the blood, largely a result of the internal diameter.
Ämnesord
- TEKNIK OCH TEKNOLOGIER -- Maskinteknik -- Strömningsmekanik och akustik (hsv//swe)
- ENGINEERING AND TECHNOLOGY -- Mechanical Engineering -- Fluid Mechanics and Acoustics (hsv//eng)
Nyckelord
- Computational fluid dynamics (CFD)
- Extracorporeal flow fraction (EFF)
- Extracorporeal membrane oxygenation (ECMO)
- Hemodynamics
- Right atrium
- Vena cava
- Venovenous (VV)
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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