Low-flow assessment of current ECMO/ECCO

Equipment Design / standards Extracorporeal Circulation / methods Extracorporeal Membrane Oxygenation / instrumentation Hemodynamics / physiology Humans Materials Testing / methods Stress, Mechanical
ARDS Centrifugal blood pumps ECCO2R ECLS ECMO

Journal

Critical care (London, England)
ISSN: 1466-609X
Titre abrégé: Crit Care
Pays: England
ID NLM: 9801902

Informations de publication

Date de publication:
06 11 2019
Historique:
received: 15 07 2019
accepted: 23 09 2019
entrez: 8 11 2019
pubmed: 7 11 2019
medline: 28 4 2020
Statut: epublish

Résumé

Extracorporeal carbon dioxide removal (ECCO High-resolution computational fluid dynamics was used to calculate the hemodynamics and hemocompatibility of three current rotary blood pumps for various pump flow rates. The hydraulic efficiency dramatically decreases to 5-10% if operating at blood flow rates below 1 L/min, the pump internal flow recirculation rate increases 6-12-fold in these flow ranges, and adverse effects are increased due to multiple exposures to high shear stress. The deleterious consequences include a steep increase in hemolysis and destruction of platelets. The role of blood pumps in contributing to adverse effects at the lower blood flow rates used during ECCO

Sections du résumé

BACKGROUND
Extracorporeal carbon dioxide removal (ECCO
METHODS
High-resolution computational fluid dynamics was used to calculate the hemodynamics and hemocompatibility of three current rotary blood pumps for various pump flow rates.
RESULTS
The hydraulic efficiency dramatically decreases to 5-10% if operating at blood flow rates below 1 L/min, the pump internal flow recirculation rate increases 6-12-fold in these flow ranges, and adverse effects are increased due to multiple exposures to high shear stress. The deleterious consequences include a steep increase in hemolysis and destruction of platelets.
CONCLUSIONS
The role of blood pumps in contributing to adverse effects at the lower blood flow rates used during ECCO

Identifiants

DOI: 10.1186/s13054-019-2622-3 PMID: 31694688 PMC: PMC6836552
pubmed: 31694688
doi: 10.1186/s13054-019-2622-3
pii: 10.1186/s13054-019-2622-3
pmc: PMC6836552
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

348

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Auteurs

Sascha Gross-Hardt (S)

Department of Cardiovascular Engineering, Medical Faculty, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.

Felix Hesselmann (F)

Department of Cardiovascular Engineering, Medical Faculty, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.

Jutta Arens (J)

Department of Cardiovascular Engineering, Medical Faculty, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.

Ulrich Steinseifer (U)

Department of Cardiovascular Engineering, Medical Faculty, Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Aachen, Germany.

Leen Vercaemst (L)

Department of Perfusion, University Hospital Gasthuisberg, Leuven, Belgium.

Wolfram Windisch (W)

Department of Pneumology and Critical Care Medicine, Cologne-Merheim Hospital, ARDS and ECMO Center, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University Hospital, Ostmerheimer Strasse 200, 51109, Cologne, Germany.

Daniel Brodie (D)

Center for Acute Respiratory Failure, Columbia University College of Physicians and Surgeons/New York-Presbyterian Hospital, New York, NY, USA.

Christian Karagiannidis (C)

Department of Pneumology and Critical Care Medicine, Cologne-Merheim Hospital, ARDS and ECMO Center, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University Hospital, Ostmerheimer Strasse 200, 51109, Cologne, Germany. Christian.Karagiannidis@uni-wh.de.
ORCID: 0000-0003-3247-2849

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Classifications MeSH

questionsmedicales.fr › Techniques d'investigation › Conception d'appareillage › Low-flow assessment of current ECMO/ECCO
questionsmedicales.fr › Procédures de chirurgie opératoire › Circulation extracorporelle › Low-flow assessment of current ECMO/ECCO
questionsmedicales.fr › Procédures de chirurgie opératoire › Circulation extracorporelle › Oxygénation extracorporelle sur oxygénateur à membrane › Low-flow assessment of current ECMO/ECCO
questionsmedicales.fr › Phénomènes physiologiques respiratoires et circulatoires › Phénomènes physiologiques cardiovasculaires › Hémodynamique › Low-flow assessment of current ECMO/ECCO
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Low-flow assessment of current ECMO/ECCO
questionsmedicales.fr › Techniques d'investigation › Test de matériaux › Low-flow assessment of current ECMO/ECCO
questionsmedicales.fr › Phénomènes physiques › Phénomènes mécaniques › Contrainte mécanique › Low-flow assessment of current ECMO/ECCO