Effects of self washout structure on the antithrombogenicity and the hemolytic properties of a centrifugal pump

Innovative experimental animal models for real-time comparison of antithrombogenicity between two oxygenators using dual extracorporeal circulation circuits and indocyanine green fluorescence imaging

BACKGROUND

Antithrombogenicity of extracorporeal membrane oxygenation (ECMO) devices, particularly oxygenators, is a current problem, with numerous studies and developments underway. However, there has been limited progress in developing methods to accurately compare the antithrombogenicity of oxygenators. Animal experiments are commonly conducted to evaluate the antithrombogenicity of devices; however, it is challenging to maintain a steady experimental environment. We propose an innovative experimental animal model to evaluate different devices in a constant experimental environment in real-time.

METHODS

This model uses two venous-arterial ECMO circuits attached to one animal (one by jugular vein and carotid artery, one by femoral vein and artery) and real-time assessment of thrombus formation in the oxygenator by indocyanine green (ICG) fluorescence imaging. Comparison studies were conducted using three pigs: one to compare different oxygenators (MERA vs. CAPIOX) (Case 1), and two to compare antithrombotic properties of the oxygenator (QUADROX) when used under different hydrodynamic conditions (continuous flow vs. pulsatile flow) (Cases 2 and 3).

RESULTS

Thrombi, visualized using ICG imaging, appeared as black dots on a white background in each oxygenator. In Case 1, differences in the site of thrombus formation and rate of thrombus growth were observed in real-time in two oxygenators. In Case 2 and 3, the thrombus region was smaller in pulsatile than in continuous conditions.

CONCLUSIONS

We devised an innovative experimental animal model for comparison of antithrombogenicity in ECMO circuits. This model enabled simultaneous evaluation of two different ECMO circuits under the same biological conditions and reduced the number of sacrificed experimental animals.

Improvement of washout flow in a centrifugal blood pump by a semi-open impeller

To reduce the possible thrombogenicity of the pump studied, pump characteristics and washout conditions were compared between a pump with a semi-open and a pump with a full-open impeller. A difference in hydrodynamic performance was observed between the semi-open impeller and the full-open impeller; the pressure in the former was less by approximately 10%, and the maximum attainable efficiency decreased from 0.41 to 0.34. The flow pattern, as visualized by the oil film method, showed that the washout condition was enhanced by addition of the shroud, especially at the bottom region of the pump where the blood flow tended to be stagnant. The stagnant area was observed in the suction side of the impeller in both models, where the vortices shed from the impeller tip contributed to the washout. It was also shown that the flow entering the bottom region was circumferentially uniform in the full-open impeller, whereas in the semi-open impeller the flow was not uniform and entered primarily from the vicinity of the outlet port. The semi-open impeller, thus, was demonstrated to have better washout conditions than the full-open impeller regardless of a slight decrease in hydrodynamic efficiency.

Analytical investigation of leakage flow in disk clearance of a magnetically suspended centrifugal impeller

Leakage flow through the disk clearance of a magnetically suspended centrifugal blood pump is essential for a good washout. An analytical approach, based on the theory of lubrication, is used to predict the leakage volume flow rate, nondimensional radial velocity, nondimensional mean pressure distribution, and comparative shear stress distribution for different disk clearance geometry under varying rotational speeds. The results showed that nondimensional mean pressure distribution and nondimensional radial velocity distribution along the clearance are independent of rotational speed. The flow through the gap depends on a nondimensional parameter S that denotes the ratio of centrifugal forces to the head generating capability of the impeller. It was found that an impeller having a lower S has less possibility of flow reversals in the gap, and gap with maximum height at the outside radius also is more susceptible to flow reversals at the impeller surface. The comparative shear stress within the gap reveals that, in general, the scalar stress is below 500 N/m2.