Pressure and flow properties of cannulae for extracorporeal membrane oxygenation I: return (arterial) cannulae
Language English Country England, Great Britain Media print
Document type Journal Article
- Keywords
- arterial, blood, cannula, extracorporeal life support, extracorporeal membrane oxygenation, pressure flow, return, water,
- MeSH
- Equipment Design instrumentation MeSH
- Hemodynamics physiology MeSH
- Cannula * MeSH
- Catheterization methods MeSH
- Humans MeSH
- Extracorporeal Membrane Oxygenation instrumentation MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
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.
Centro Hospitalar de Lisboa Central Hospital Curry Cabral Lisbon Portugal
Department of Intensive Care Hôpital Erasme Université Libre de Bruxelles Brussels Belgium
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
Pediatric Intensive Care Unit Children's Hospital Bambino Gesù IRCCS Rome Italy
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
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