Thesis
Development of a novel single input bi-directional cannula for extracorporeal membrane oxygenation
- Creator
- Rights statement
- Awarding institution
- University of Strathclyde
- Date of award
- 2024
- Thesis identifier
- T17169
- Person Identifier (Local)
- 201952704
- Qualification Level
- Qualification Name
- Department, School or Faculty
- Abstract
- Backgrounds: Arterial cannulation for peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO) causes a risk of disrupting blood flow, which can lead to neurological injury or limb ischaemia. The current arterial bi-directional cannula presents risks for both haematological and vascular injury. This study aims to develop a new bi-directional cannula designed for improving perfusion and reducing associated complications. Methods: Six bi-directional cannulae were tested, each with a primary diameter of 4.33 millimetre (mm) and a secondary distal lumen of 1.80 mm, had three radius curve (R) features (1.40 mm: 1st iteration, 1.00 mm: 2nd iteration, and 0.85 mm: 3rd iteration, respectively), and three underpart features (sinus: 4th iteration, ramp: 5th iteration, and sinus-ramp: 6th iteration, respectively). These cannulae were evaluated with computational fluid dynamics (CFD) to characterise blood flow and wall shear stress (WSS), dye and particle tracking to visualise flow, haemodynamic performance to identify pressure-flow relationship and volume distribution, and haematological response to define blood components depletion and haemolysis status. Results: In CFD, there were no differences in the flow path regarding the primary lumen outflow. Secondary lumen flow of 1st iteration was found to direct flow to the vessel wall with highest WSS. Others improved flow and reduced WSS impacts, especially in 6th iteration. Dye injection showed a symmetrical, central flow trajectory in 2nd, 5th, and 6th iteration. Furthermore, particle tracking verified this in 2nd and 6th iterations. Pressure-flow relationship found that at 3 LPM provided pressure gradient less than 100 mmHg in all cannulae. Volume flow distribution, the 6th iteration showed higher output volumes at secondary lumen than 1st and 2nd iteration. The red blood cells, haemoglobin, white blood cells and platelets in all groups had decreased. Notably 2nd iteration was superior result in haemolysis analysis as significant lower plasma-free haemoglobin, and normalised index of haemolysis. Conclusion: Findings of the in-silico and in-vitro experiments indicate that the 2nd and 6th iterations effectively demonstrated to centreline and lower risk of jet impact to vessel wall. Additionally, 2nd iteration demonstrate possibility of improving arterial cannulation in peripheral VA-ECMO as shown in haematological evidence. Keywords: ECMO, Limb ischemia, Bi-directional cannula, Distal perfusion
- Advisor / supervisor
- Gourlay, Terry
- Robertson, Craig
- Resource Type
- DOI
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