Clinic for Thoracic Surgery, University Hospital RWTH Aachen, Aachen, Germany.
Institute of Physiology, RWTH Aachen University, Aachen, Germany.
Int J Artif Organs. 2023 May;46(5):295-302. doi: 10.1177/03913988231168163. Epub 2023 Apr 12.
Aim of this work was to characterize possible central anatomical configurations in which a future artificial lung (AL) could be connected, in terms of oxygenation performance.
Pulmonary and systemic circulations were simulated using a numerical and an in vitro approach. The in vitro simulation was carried out in a mock loop in three phases: (1) normal lung, (2) pulmonary shunt (50% and 100%), and (3) oxygenator support in three anatomical configurations: right atrium-pulmonary artery (RA-PA), pulmonary artery-left atrium (PA-LA), and aorta-left atrium (Ao-LA). The numerical simulation was performed for the oxygenator support phase. The oxygen saturation (SO) of the arterial blood was plotted over time for two percentages of pulmonary shunt and three blood flow rates through the oxygenator.
During the pulmonary shunt phase, SO reached a steady state value (of 68% for a 50% shunt and of nearly 0% for a 100% shunt) 20 min after the shunt was set. During the oxygenator support phase, physiological values of SO were reached for RA-PA and PA-LA, in case of a 50% pulmonary shunt. For the same conditions, Ao-LA could reach a maximum SO of nearly 60%. Numerical results were congruous to the in vitro simulation ones.
Both in vitro and numerical simulations were able to properly characterize oxygenation properties of a future AL depending on its placement. Different anatomical configurations perform differently in terms of oxygenation. Right to right and right to left connections perform better than left to left ones.
本研究旨在探讨未来人工肺(AL)在氧合性能方面可能的中央解剖结构配置。
采用数值模拟和体外模拟两种方法模拟肺循环和体循环。体外模拟在三个阶段进行:(1)正常肺,(2)肺分流(50%和 100%),(3)在三种解剖结构配置下进行氧合器支持:右心房-肺动脉(RA-PA)、肺动脉-左心房(PA-LA)和主动脉-左心房(Ao-LA)。数值模拟在氧合器支持阶段进行。绘制动脉血血氧饱和度(SO)随时间的变化曲线,用于两种肺分流百分比和三种氧合器血流速率。
在肺分流阶段,分流设置 20 分钟后,SO 达到稳定状态值(50%分流时为 68%,100%分流时接近 0%)。在氧合器支持阶段,对于 50%的肺分流,RA-PA 和 PA-LA 达到了生理上的 SO 值。在相同条件下,Ao-LA 可以达到近 60%的最大 SO 值。数值结果与体外模拟结果一致。
体外和数值模拟均能根据人工肺的位置正确描述其氧合性能。不同的解剖结构在氧合方面表现不同。右至右和右至左连接的性能优于左至左连接。