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 language | English |
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Article number | 0267659120926009 |
Pages (from-to) | 736-744 |
Number of pages | 9 |
Journal | Perfusion |
Volume | 35 |
Issue number | 8 |
Early online date | 5 Jun 2020 |
DOIs | |
Publication status | Published - Nov 2020 |
Keywords
- extracorporeal membrane oxygenation
- dual lumen
- cannula
- venous
- pressure-flow
- blood
- water
- NON-NEWTONIAN PROPERTIES
- BLOOD
- ECMO
- RECIRCULATION
- PERFORMANCE
- THROMBOSIS
- AWAKE