Thesis

Development of a superabsorber based haemofiltration technology for use in paediatric cardiac surgery

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Awarding institution
  • University of Strathclyde
Date of award
  • 2016
Thesis identifier
  • T14441
Person Identifier (Local)
  • 201080778
Qualification Level
Qualification Name
Department, School or Faculty
Abstract
  • Cardiopulmonary bypass is known to cause great changes in a patient’s physiological fluid homeostasis which frequently results in fluid accumulation in the interstitial space (edema). The associated inflammatory response can, in severe cases, result in systemic immune response syndrome, acute respiratory distress syndrome, and organ failure. Modified Ultrafiltration (MUF) involves pumping blood through a haemofilter post-bypass to remove excess plasma, and has been shown to successfully moderate haemodilution and the inflammatory response and improve clinical outcomes in paediatric patients for whom edema is a serious morbidity. In this research project, the current MUF technique is combined with a new superabsorber based haemofiltration technology to develop a novel haemofiltration device. Design concepts were researched and the optimal device configuration was determined. Laboratory testing with bovine blood, computational modelling of blood flow and scanning electron microscope imaging of the control membrane highlighted the importance of both utilising flow disruption techniques to limit fouling, and controlling the swelling behaviour of the superabsorber material, in achieving rapid haemofiltration. The device is able to achieve passive, chemically driven haemofiltration at a fixed blood flow rate and is designed such that it requires minimal input from clinical staff to be suitable for deployment in a clinical setting. The haemoconcentration time is close to current MUF procedures but with further refinement of the system, equalling the MUF time for current procedures is certainly achievable. The blood haemoconcentrated by the device was of good quality with no significant change in cell counts, cell morphology measures, or haemoglobin level measures after 60mins of MUF indicating little to no impact upon the blood constituents or haemolysis induced by the device. The device did not demonstrate selective removal of pro-inflammatory mediators but similarly there was no increase in pro-inflammatory mediator concentrations observed. Further investigation of the inflammatory mediator impact is recommended.
Advisor / supervisor
  • Gourlay, Terry
Resource Type
Note
  • Previously held under moratorium from 30th November 2016 until 30th November 2021
DOI
Date Created
  • 2016
Former identifier
  • 9912537087302996

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