Hemodynamic performance limits of the neonatal Double-Lumen cannula

dc.authorid0000-0001-5485-5440
dc.contributor.authorRasooli, Reza
dc.contributor.authorJamil, Muhammad
dc.contributor.authorRezaeimoghaddam, Mohammad
dc.contributor.authorYıldız, Yahya
dc.contributor.authorSalihoğlu, Ece
dc.contributor.authorPekkan, Kerem
dc.date.accessioned2021-05-07T09:18:33Z
dc.date.available2021-05-07T09:18:33Z
dc.date.issued2021
dc.departmentİstanbul Medipol Üniversitesi, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Anesteziyoloji ve Reanimasyon Ana Bilim Dalı
dc.description.abstractVenovenous extracorporeal membrane oxygenation (VV-ECMO) is the preferred surgical intervention for patients suffering from severe cardiorespiratory failure, also encountered in SARS-Cov-2 management. The key component of VV-ECMO is the double-lumen cannula (DLC) that enables single-site access. The biofluid dynamics of this compact device is particularly challenging for neonatal patients due to high Reynolds numbers, tricuspid valve location and right-atrium hemodynamics. In this paper we present detailed findings of our comparative analysis of the right-atrial hemodynamics and salient design features of the 13Fr Avalon Elite DLC (as the clinically preferred neonatal cannula) with the alternate Origen DLC design, using experimentally validated computational fluid dynamics. Highly accurate 3D-reconstructions of both devices were obtained through an integrated optical coherence tomography and micro-CT imaging approach. Both cannula configurations displayed complex flow structures inside the atrium, superimposed over predominant recirculation regimes. We found that the Avalon DLC performed significantly better than the Origen alternative, by capturing 80% and 94% of venous blood from the inferior and superior vena cavae, respectively and infusing the oxygenated blood with an efficiency of more than 85%. The micro-scale geometric design features of the Avalon DLC that are associated with superior hemodynamics were investigated through 14 parametric cannula configurations. These simulations showed that the strategic placement of drainage holes, the smooth infusion blood stream diverter and efficient distribution of the venous blood capturing area between the vena cavae are associated with robust blood flow performance. Nevertheless, our parametric results indicate that there is still room for further device optimization beyond the performance measurements for both Avalon and Origen DLC in this study. In particular, the performance envelope of malpositioned cannula and off-design conditions require additional blood flow simulations for analysis.
dc.identifier.citationRasooli, R., Jamil, M., Rezaeimoghaddam, M., Yıldız, Y., Salihoğlu, E. ve Pekkan, K. (2021). Hemodynamic performance limits of the neonatal Double-Lumen cannula. Journal of Biomechanics, 121. https://dx.doi.org/10.1016/j.jbiomech.2021.110382
dc.identifier.doi10.1016/j.jbiomech.2021.110382
dc.identifier.issn0021-9290
dc.identifier.scopusqualityQ1
dc.identifier.urihttps://dx.doi.org/10.1016/j.jbiomech.2021.110382
dc.identifier.urihttps://hdl.handle.net/20.500.12511/6825
dc.identifier.volume121
dc.identifier.wosqualityQ3
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherElsevier Ltd
dc.relation.ispartofJournal of Biomechanicsen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.relation.tubitakinfo:eu-repo/grantAgreement/TUBITAK/SOBAG/118M369
dc.rightsinfo:eu-repo/semantics/embargoedAccess
dc.subjectBiofluid Mechanics
dc.subjectCardiovascular Devices
dc.subjectCongenital Heart Defects
dc.subjectHemodynamics
dc.subjectHemolysis and Thrombogenicity
dc.subjectMicro-CT
dc.titleHemodynamic performance limits of the neonatal Double-Lumen cannula
dc.typeArticle

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