Pressure and flow properties of dual-lumen cannulae for extracorporeal membrane oxygenation

Lars Mikael Broman*, C. Jerker Westlund, Martijn Gilbers, Luisa Perry da Camara, Lisa Prahl Wittberg, Fabio Silvio Taccone, Maximilian Malfertheiner, Matteo Di Nardo, Justyna Swol, Leen Vercaemst, Nicholas A. Barrett, Federico Pappalardo, Jan Belohlavek, Mirko Belliato, Roberto Lorusso

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)

Abstract

Introduction:

In the last decade, dual-lumen cannulae have been increasingly applied in patients undergoing extracorporeal life support. Well-performing vascular access is crucial for efficient extracorporeal membrane oxygenation support; thus, guidance for proper cannulae size is required. Pressure-flow charts provided by manufacturers are often based on tests performed using water, rarely blood. However, blood is a shear-thinning and viscoelastic fluid characterized by different flow properties than water.

Methods:

We performed a study evaluating pressure-flow curves during standardized conditions using human whole blood in two commonly available dual-lumen cannulae used in neonates, pediatric, and adult patients. Results were merged and compared with the manufacturer's corresponding curves obtained from the public domain.

Results:

The results showed that using blood as compared with water predominantly influenced drainage flow. A 10-80% higher pressure-drop was needed to obtain same drainage flow (hematocrit of 26%) compared with manufacturer's water charts in 13-31 Fr bi-caval dual-lumen cannulae. The same net difference was found in cavo-atrial cannulae (16-32 Fr), where a lower drainage pressure was required (Hct of 26%) compared with the manufacturer's test using blood with an Hct of 33%. Return pressure-flow data were similar, independent whether pumping blood or water, to the data reported by manufacturers.

Conclusion:

Non-standardized testing of pressure-flow properties of extracorporeal membrane oxygenation dual-lumen cannulae prevents an adequate prediction of pressure-flow results when these cannulae are used in patients. Properties of dual-lumen cannulae may vary between sizes within same cannula family, in particular concerning the drainage flow.

Original languageEnglish
Pages (from-to)736-744
Number of pages9
JournalPerfusion
Volume35
Issue number8
Early online date5 Jun 2020
DOIs
Publication statusPublished - Nov 2020

Keywords

  • extracorporeal membrane oxygenation
  • dual lumen
  • cannula
  • venous
  • pressure-flow
  • blood
  • water
  • NON-NEWTONIAN PROPERTIES
  • BLOOD
  • ECMO
  • RECIRCULATION
  • PERFORMANCE
  • THROMBOSIS
  • AWAKE

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