VARIABLE ROTATIONAL SPEED SUBSTANTIALLY REDUCE THE RATE OF HEMOLYSIS WITHIN IN-HOUSE ROLLER PUMP

článek ve sborníku mimo WoS a Scopus

en

In clinical practice, roller pumps (RPs) are mostly used in two medical methods – veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and cardio-pulmonary bypass (CPB). Currently, centrifugal pumps (CPs) stand the competition in the VA-ECMO, mainly due to the shorter lifespan of peristaltic tubing [1]. However, the hemolysis-related complications (e.g., hemolytic anemia, hyperbilirubinemia, and acute renal failure) are usually much more prominent in CPs [2][3]. Main difference between CP and RP is that the former provides continuous flow due to the inherent design of the pump while the latter produces pulsatile flow. The pulsatile flow has been attributed to several benefits such as shorter need of intensive care, better microcirculation, lower inflammatory events, and better perfusion to organs [4]. Moreover, the correct synchronization between pulsatile flow and ECG may support the heart performance during VA-ECMO session [5]. Even though the study [5] demonstrated the pulsatile feasibility of CPs (achieved by varying the rotational speed), it carries certain limitations (e.g., the pulsatile effect diminishes with higher flow rates and may increase hemolysis). On the other hand, RPs generate intrinsically pulsatile flow, and the pressure and flow waveforms can be widely modulated through varying rotational speed profile (RSP) [6]. Since hemolysis is a crucial factor in clinical practice, the paper focuses on its evaluation within an in-house developed two-roller pump with full occlusion using computational simulations with experimentally obtained boundary conditions.

In clinical practice, roller pumps (RPs) are mostly used in two medical methods – veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and cardio-pulmonary bypass (CPB). Currently, centrifugal pumps (CPs) stand the competition in the VA-ECMO, mainly due to the shorter lifespan of peristaltic tubing [1]. However, the hemolysis-related complications (e.g., hemolytic anemia, hyperbilirubinemia, and acute renal failure) are usually much more prominent in CPs [2][3]. Main difference between CP and RP is that the former provides continuous flow due to the inherent design of the pump while the latter produces pulsatile flow. The pulsatile flow has been attributed to several benefits such as shorter need of intensive care, better microcirculation, lower inflammatory events, and better perfusion to organs [4]. Moreover, the correct synchronization between pulsatile flow and ECG may support the heart performance during VA-ECMO session [5]. Even though the study [5] demonstrated the pulsatile feasibility of CPs (achieved by varying the rotational speed), it carries certain limitations (e.g., the pulsatile effect diminishes with higher flow rates and may increase hemolysis). On the other hand, RPs generate intrinsically pulsatile flow, and the pressure and flow waveforms can be widely modulated through varying rotational speed profile (RSP) [6]. Since hemolysis is a crucial factor in clinical practice, the paper focuses on its evaluation within an in-house developed two-roller pump with full occlusion using computational simulations with experimentally obtained boundary conditions.

ROLLER PUMP; HEMOLYSIS

09.07.2023

Maastricht

ESB 2023 BOOK OF ABSTRACTS

28

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