Non-newtonian behavior of whole blood in a large diameter tube

Specification and Evaluation of Plasticizer Migration Simulants for Human Blood Products: A Delphi Study

Potentially toxic plasticizers are commonly added to polyvinyl chloride medical devices for transfusion in order to improve their flexibility and workability. As the plasticizers are not chemically bonded to the PVC, they can be released into labile blood products (LBPs) during storage. Ideally, LBPs would be used in laboratory studies of plasticizer migration from the medical device. However, short supply (i.e., limited stocks of human blood in collection centres) has prompted the development of specific simulants for each type of LBP in the evaluation of new transfusion devices. We performed a Delphi study with a multidisciplinary panel of 24 experts. In the first (qualitative) phase, the panel developed consensus definitions of the specification criteria to be met by each migration simulant. Next, we reviewed the literature on techniques for simulating the migration of plasticizers into LBPs. A questionnaire was elaborated and sent out to the experts, and the replies were synthesized in order to obtain a consensus. The qualitative study established specifications for each biological matrix (whole blood, red blood cell concentrate, plasma, and platelet concentrate) and defined the criteria required for a suitable LBP simulant. Ten criteria were suggested: physical and chemical characteristics, opacity, form, stability, composition, ability to mimic a particular clinical situation, ease and safety of use, a simulant–plastic interaction correlated with blood, and compatibility with analytical methods. The questionnaire data revealed a consensus on the use of natural products (such as pig’s blood) to mimic the four LBPs. Opinions diverged with regard to synthetic products. However, an isotonic solution and a rheological property modifier were considered to be of value in the design of synthetic simulants. Consensus reached by the Delphi group could be used as a database for the development of simulants used to assess the migration of plasticizers from PVC bags into LBPs.

In vivo observation of the hypo-echoic "black hole" phenomenon in rat arterial bloodstream: a preliminary Study

The "black hole," a hypo-echoic hole at the center of the bloodstream surrounded by a hyper-echoic zone in cross-sectional views, has been observed in ultrasound backscattering measurements of blood with red blood cell aggregation in in vitro studies. We investigated whether the phenomenon occurs in the in vivo arterial bloodstream of rats using a high-frequency ultrasound imaging system. Longitudinal and cross-sectional ultrasound images of the rat common carotid artery (CCA) and abdominal aorta were obtained using a 40-MHz ultrasound system. A high-frame-rate retrospective imaging mode was employed to precisely examine the dynamic changes in blood echogenicity in the arteries. When the imaging was performed with non-invasive scanning, blood echogenicity was very low in the CCA as compared with the surrounding tissues, exhibiting no hypo-echoic zone at the center of the vessel. Invasive imaging of the CCA by incising the skin and subcutaneous tissues at the imaging area provided clearer and brighter blood echo images, showing the "black hole" phenomenon near the center of the vessel in longitudinal view. The "black hole" was also observed in the abdominal aorta under direct imaging after laparotomy. The aortic "black hole" was clearly observed in both longitudinal and cross-sectional views. Although the "black hole" was always observed near the center of the arteries during the diastolic phase, it dissipated or was off-center along with the asymmetric arterial wall dilation at systole. In conclusion, we report the first in vivo observation of the hypo-echoic "black hole" caused by the radial variation of red blood cell aggregation in arterial bloodstream.

MR current density and conductivity imaging: the state of the art

Current density imaging (CDI) is an imaging technique that measures electrical current density distributions in a volume of material or tissue, which can be imaged using magnetic resonance imaging (MRI). Measurements of current density are obtained by applying an external current to the material/tissue during an MRI acquisition. The magnetic fields produced by the applied current are mapped onto the phase image of the MRI acquisition. The phase images are processed to compute the current density distribution. Performing CDI requires an MRI system, additional hardware, a modified pulse sequence (PSD) and data processing software. Greig C. Scott, Michael L.G. Joy and R. Mark Henkelman developed CDI in 1988 at the University of Toronto (Canada). The CDI Research Group is presently based at the University of Toronto and is supervised by the author. This paper describes the CDI technique, its applications by this and other groups and recently proposed methods for electrical conductivity imaging based on the technique.

Echogenicity variations from porcine blood II: the "bright ring" under oscillatory flow

Echogenicity variations from porcine blood were observed in a mock flow loop under pulsatile flow in a series of experiments (Paeng et al. 2004). In this paper, oscillatory flow was generated to further investigate the cyclic and radial variation of blood echogenicity and its origin and mechanisms by several parameters, including stroke volume, stroke rate, mean steady flow and transducer angle, using a GE LOGIQ 700 Expert system. The echogenicity at the center of the tube was enhanced during acceleration and lower during deceleration, and the expansion and collapse of the "bright ring" was observed twice per cycle. The "black hole," a central echo-poor zone surrounded by a hyperechoic zone, was barely observable under oscillatory flow, and these patterns differed from those under pulsatile flow. The cyclic and radial variation of echogenicity under oscillatory flow was affected by such hemodynamic parameters as stroke volume, stroke rate and mean steady flow. It was suggested that rouleaux might be aligned at an angle of about 25 degrees relative to the tube axis during the acceleration phase, based on the experimental results reaching a maximum of the echogenicity variation at a transducer angle of 25 degrees. Radial distribution of rouleaux alignments was proposed to be another important factor to blood echogenicity variation, in addition to combined effects of shear rate and flow acceleration on erythrocyte aggregation and blood echogenicity. The weak cyclic variation of echogenicity was also observed from the porcine erythrocyte suspensions under pure oscillatory flow, but not under pulsatile flow. It is postulated that the echogenicity variations from erythrocyte suspensions are from red cell deformation.

Simulated lipoprotein transport in the wall of branched arteries

Study of arterial blood flow dynamics improves our understanding of the development of cardiovascular diseases such as atherosclerosis. The transport and accumulation of macromolecules in the arterial wall can be influenced by local fluid mechanics. We used numeric simulations to investigate such transport in a T-junction model. Presumably an in vitro experiment would consist of gel segments inserted in the walls of a mechanical flow T-junction model near branch points where separation and recirculation zones are expected. The transport of low density lipoprotein (LDL) was investigated theoretically at these sites in a two dimensional numeric T-branch model. In the numeric model, the hydraulic conductivity of the porous gel wall segments was varied for a fixed species diffusivity to provide simulations with wall transmural Peclet numbers ranging from 0.3 to 30. Steady state flow patterns in the lumen of the two dimensional T-branch were simulated at Reynolds numbers of 250 and 500, using the software package FIDAP 7.61 to implement the finite element method. The simulations demonstrated that wall Peclet numbers greater than 1.0 were needed to achieve species concentration gradients within the wall that varied in the axial direction, thereby reflecting the influence of disturbed flow and pressure patterns in the lumen. As expected, the transmural concentration gradients were steeper when convection predominated. Blood flow in the lumen can influence the distribution of macromolecules in the arterial wall and needs to be investigated for the relevance to atherosclerosis.

Mean blood velocity measurement with a narrow ultrasound beam and an asymmetric velocity profile

Previous discussions of the measurement of spatial mean blood velocity using Doppler ultrasound with a narrow beam have required the velocity profile in the cross section to be symmetric about the vessel axis. A type of asymmetry is put forward which incurs no error in mean velocity measurement when the beam is directed through the point of maximum velocity. Assuming correct alignment of the beam, errors due to profile asymmetry are, therefore, related to the degree of departure of the asymmetry from this acceptable form.

Origin of the Doppler ultrasound spectrum from blood

Backscattering of an incident ultrasound beam by blood gives rise to a Doppler spectrum whose characteristics are affected not only by the velocity distribution, but also by certain basic aspects of the RBC's behavior. Starting from fundamental assumptions, an explicit expression is derived for the Doppler spectrum in terms of the variance in the scatterer number density and the backscattering cross section. This shows that the Doppler power at a given frequency is weighted by the backscattering cross section and the manner in which the red blood cells (RBC's) are packed (packing factor). Since spatial variations in the flow field can result in changes in the variance and backscattering cross section, the mean Doppler frequency will not necessarily be proportional to the mean flow through the sample volume. Experimental results for two different flow fields are used to illustrate these effects. The implications of these findings are discussed in relation to volumetric flow estimation and the power mode display used in some color Doppler flow imaging systems.

On the Doppler signal from a steady flow asymmetrical stenosis model: effects of turbulence

A steady flow model with a 70% (by area) asymmetrical stenosis was used to examine how changing flow regimes (laminar to turbulent) affect the Doppler signal. Human red blood cells (RBCs) (Hct = 42%) in saline were employed at a flow rate corresponding to a Reynold's number of approximately 545. A dilute suspension of 4% fixed RBCs was also used for the purpose of backscattered power comparison. Measurements of the Doppler signal enabled the backscattered power, time domain statistics, frequency spectra, frequency domain statistics, various spectral indices, autocorrelation function and decorrelation time to be calculated as a function of distance from the stenosis. It is shown that the characteristics of the Doppler signal measured at each site provide information on the nature of the insonated flow field and these correlate well with those expected. The results demonstrate that the onset of turbulence not only affects the Doppler spectrum but also has a profound effect on the signal power, the decorrelation time and the signal statistics.