Boschetti Federica, Cook Keith E, Perlman Carrie E, Mockros Lyle F
Laboratory of Biological Structure Mechanics, Department of Structural Engineering, Politecnico di Milano, Milan, Italy.
ASAIO J. 2003 Nov-Dec;49(6):678-86. doi: 10.1097/01.mat.0000094041.69991.0d.
This report discusses theoretical effects of blood flow pulsatility upon the rate of oxygen transfer in artificial lungs, demonstrates the effects with in vitro tests upon commercial oxygenators, and applies the theory to these oxygenators and to a thoracic artificial lung. Steady flow gas transfer theory is applied to pulsatile flow by using the instantaneous value of flow rate at each instant of time, that is, quasi-steady gas transfer. The theory suggests that the local rate of oxygen transfer for a given device and blood composition is proportional to the flow rate to a power less than unity and to the hemoglobin saturation level. It predicts, for some cases, overall reduced rates of gas transfer for pulsatile flow relative to those at steady flow for the same mean blood flow rates. In vitro bovine blood tests, using pediatric oxygenators, a pulsatile pump, and an adjustable compliance chamber, indicate a significant average 10% reduction of oxygen transfer for pulsatile flow relative to steady flow. The application of the theory to the oxygenators predicts gas transfer values that are in agreement with those measured during the experiments. The results have implications in the design of implantable thoracic artificial lungs, which should include a compliant section to dampen the cardiac pulse. A relatively small compliance (0.2 ml/mm Hg) at the thoracic artificial lung inlet is sufficient to obtain approximately 95% of steady flow oxygen transfer.
本报告讨论了血流搏动性对人工肺中氧传递速率的理论影响,通过对商用氧合器进行体外测试证明了这些影响,并将该理论应用于这些氧合器以及胸腔人工肺。通过使用每个时刻的流速瞬时值,即准稳态气体传递,将稳态流气体传递理论应用于搏动流。该理论表明,对于给定的装置和血液成分,局部氧传递速率与流速的幂成正比,该幂小于1,并且与血红蛋白饱和度水平成正比。对于某些情况,它预测搏动流相对于相同平均血流速率下的稳态流,气体传递的总体速率会降低。使用儿科氧合器、搏动泵和可调节顺应性腔室进行的体外牛血测试表明,相对于稳态流,搏动流的氧传递平均显著降低10%。将该理论应用于氧合器所预测的气体传递值与实验期间测量的值一致。这些结果对可植入胸腔人工肺的设计具有启示意义,该人工肺应包括一个顺应性部分以缓冲心脏脉冲。胸腔人工肺入口处相对较小的顺应性(0.2 ml/mm Hg)足以获得约95%的稳态流氧传递。