Rorro Federico, Broman Lars Mikael, Prahl Wittberg Lisa
FLOW, Department of Engineering Mechanics, KTH Royal Institute of Technology, Stockholm, Sweden.
ECMO Centre Karolinska, Pediatric Perioperative Medicine and Intensive Care, Karolinska University Hospital, Stockholm, Sweden.
Cardiovasc Eng Technol. 2025 Apr;16(2):238-250. doi: 10.1007/s13239-024-00770-x. Epub 2025 Feb 10.
Extracorporeal membrane oxygenation is a lifesaving treatment for patients with refractory acute respiratory, circulatory, or combined cardiopulmonary failure. The patient is cannulated with one or two cannulae for drainage and reinfusion of blood. Blood is drained from the patient, pumped through a membrane lung for oxygenation and returned to the patient. Treatment efficiency depends on correct cannula positioning and interactions between drainage and reinfusion cannula.
An experimental setup was built to study the isolated drainage performance of 24 Fr rigid models of a blunt and lighthouse tip cannula, both when centered and when tilted towards the vessel wall. Planar particle image velocimetry was used to investigate the flow field with water as the fluid medium.
For similar flow configuration, higher shear stresses were recorded in the blunt tip rather than lighthouse tip cannula. Moreover, in the lighthouse tip cannula, side-holes furthest from the tip (proximal side-holes) had the highest drainage. Results did not change substantially when the cannula was tilted towards the vessel wall.
The effective drainage point of the lighthouse tip cannula was located near the proximal side-holes. Lower shear stresses were recorded in the lighthouse tip cannula when compared with the blunt tip cannula, for all considered flow rate ratios and cannula positions.
体外膜肺氧合是治疗难治性急性呼吸、循环或心肺联合衰竭患者的一种挽救生命的治疗方法。患者通过一根或两根插管进行置管,用于血液引流和回输。血液从患者体内引出,通过膜肺进行氧合后再回输到患者体内。治疗效率取决于插管的正确定位以及引流和回输插管之间的相互作用。
构建了一个实验装置,用于研究24 Fr钝头和灯塔头插管刚性模型在居中及向血管壁倾斜时的孤立引流性能。采用平面粒子图像测速技术,以水为流体介质研究流场。
在相似的流动配置下,钝头插管记录到的剪切应力高于灯塔头插管。此外,在灯塔头插管中,离尖端最远的侧孔(近端侧孔)引流效果最佳。当插管向血管壁倾斜时,结果没有实质性变化。
灯塔头插管的有效引流点位于近端侧孔附近。在所有考虑的流速比和插管位置下,与钝头插管相比,灯塔头插管记录到的剪切应力更低。