Adequate extracorporeal membrane oxygenation support in the adult requires cannulae permitting blood flows up to 6-8 L/minute. In accordance with Poiseuille's law, flow is proportional to the fourth power of cannula inner diameter and inversely proportional to its length. Poiseuille's law can be applied to obtain the pressure drop of an incompressible, Newtonian fluid (such as water) flowing in a cylindrical tube. However, as blood is a pseudoplastic non-Newtonian fluid, the validity of Poiseuille's law is questionable for prediction of cannula properties in clinical practice. Pressure-flow charts with non-Newtonian fluids, such as blood, are typically not provided by the manufacturers. A standardized laboratory test of return (arterial) cannulae for extracorporeal membrane oxygenation was performed. The aim was to determine pressure-flow data with human whole blood in addition to manufacturers' water tests to facilitate an appropriate choice of cannula for the desired flow range. In total, 14 cannulae from three manufacturers were tested. Data concerning design, characteristics, and performance were graphically presented for each tested cannula. Measured blood flows were in most cases 3-21% lower than those provided by manufacturers. This was most pronounced in the narrow cannulae (15-17 Fr) where the reduction ranged from 27% to 40% at low flows and 5-15% in the upper flow range. These differences were less apparent with increasing cannula diameter. There was a marked disparity between manufacturers. Based on the measured results, testing of cannulae including whole blood flows in a standardized bench test would be recommended.

2nd Department of Medicine Department of Cardiovascular Medicine General University Hospital Prague and 1st Faculty of Medicine Charles University Prague Prague Czech Republic

Advanced Heart Failure and Mechanical Circulatory Support Program San Raffaele Hospital Vita Salute San Raffaele University Milan Italy

Centro Hospitalar de Lisboa Central Hospital Curry Cabral Lisbon Portugal

Department of Cardio Thoracic Surgery Heart and Vascular Centre Cardiovascular Research Institute Maastricht Maastricht University Medical Hospital Maastricht The Netherlands

Department of Critical Care and Severe Respiratory Failure Service Guy's and St Thomas' NHS Foundation Trust London UK

Department of Intensive Care Hôpital Erasme Université Libre de Bruxelles Brussels Belgium

Department of Internal Medicine 2 Cardiology and Pneumology University Medical Center Regensburg Regensburg Germany

Department of Perfusion University Hospital Gasthuisberg Leuven Belgium

Department of Physiology and Pharmacology Karolinska Institutet Stockholm Sweden

Department of Physiology Maastricht University Maastricht The Netherlands

Department of Pulmonology Intensive Care Medicine Paracelsus Medical University Nuremberg Germany

ECMO Center Karolinska Department of Pediatric Perioperative Medicine and Intensive Care Karolinska University Hospital Stockholm Sweden

Pediatric Intensive Care Unit Children's Hospital Bambino Gesù IRCCS Rome Italy

The Linné Flow Centre and BioMEx Centre Department of Mechanics KTH Royal Institute of Technology Stockholm Sweden

U O C Anestesia e Rianimazione 1 Fondazione IRCCS Policlinico San Matteo Pavia Italy

Working Group on Innovation and Technology EuroElso Newcastle upon Tyne UK

Perfusion. 2020 Apr;35(3):271-272. doi: 10.1177/0267659119867182. PubMed

Perfusion. 2021 Apr;36(3):322-323. doi: 10.1177/0267659120947376. PubMed

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