Stammers Alfred H, Vang See N, Mejak Brian L, Rauch Eric D
Division of Clinical Perfusion Education, School of Allied Health Professions, University of Nebraska Medical Center, Omaha, Nebraska, USA.
J Extra Corpor Technol. 2003 Jun;35(2):143-51.
Rheological changes occurring with the conduct of cardiopulmonary bypass affect the distribution of blood throughout the cardiovascular system. The purpose of this study was to evaluate the effects of changing physical characteristics of fluid on the dynamics of blood flow in an in vitro model. An extracorporeal model simulating coronary vessel constriction was designed that consisted of tubing with varying internal diameters. Tubing sizes were selected as percentage reductions (11, 33, 56, and 78%) of a normal sized (3.6 mm) coronary artery. Flow rates were randomly varied between 150 and 300 mL min(-1) temperatures of 6 and 37 degrees C, and hematocrits of 0, 20, and 38%. Endpoints included viscosity, pressure drop, and volume distribution. As temperature fell from 37 to 6 degrees C, viscosity increased with hematocrit as follows: 192% at 0%, 225% at 20%, and 249% at 38%, p < .001. Pressure drop increased significantly across each tubing size ranging from 173-351%, p < .01, as fluid was cooled from 37 to 6 degrees C. However, intraconduit statistical differences in volumetric distribution of flow were not achieved. Although the induced hypothermia resulted in increases in resistance, statistical significance was only seen in the smallest lumen conduit. In conclusion, the effects of changing temperature has profound influence on fluid distribution secondary to changing blood viscosity in an in vitro model for fluid distribution. Knowledge of such flow alterations may aid in determining optimal perfusion strategies where vessel constrictions are encountered.
体外循环过程中发生的流变学变化会影响血液在整个心血管系统中的分布。本研究的目的是在体外模型中评估流体物理特性变化对血流动力学的影响。设计了一个模拟冠状动脉狭窄的体外模型,该模型由内径不同的管道组成。管道尺寸选择为正常尺寸(3.6 mm)冠状动脉的百分比缩减(11%、33%、56%和78%)。流速在150至300 mL min⁻¹之间随机变化,温度为6℃和37℃,血细胞比容为0%、20%和38%。观察指标包括粘度、压降和体积分布。当温度从37℃降至6℃时,粘度随血细胞比容增加,具体如下:0%时增加192%,20%时增加225%,38%时增加249%,p <.001。当流体从37℃冷却至6℃时,各管道尺寸的压降显著增加,范围为173 - 351%,p <.01。然而,未实现管内血流体积分布的统计学差异。尽管诱导性低温导致阻力增加,但仅在最小内径的管道中观察到统计学意义。总之,在体外流体分布模型中,温度变化通过改变血液粘度对流体分布产生深远影响。了解此类血流改变可能有助于确定遇到血管狭窄时的最佳灌注策略。