Thesis
Novel mechanisms for thermal control in ECMO
- Creator
- Rights statement
- Awarding institution
- University of Strathclyde
- Date of award
- 2016
- Thesis identifier
- T14445
- Person Identifier (Local)
- 200990763
- Qualification Level
- Qualification Name
- Department, School or Faculty
- Abstract
- BackgroundExtracorporeal membrane oxygenation (ECMO) is a temporary treatment forpatients who suffer from impaired heart- and/or lung functions to degrees of inadequate self-sustainability. The use of an artificial ECMO circuit provides supportto the patient to enable the healing processes to occur, with the ultimate objectiveof returning back to normal organ functions. Since the first application in 1972,ECMO has been responsible for decreasing morbidity in many challenged patientgroups, particularly in neonatal care. However, despite the technical advancements,morbidity and mortality rates still remain high, largely based on the invasive natureof the therapy and technical imperfections of the system and the tendency to deployECMO as a therapy of last resort. ECMO is associated with many complications,but the focus of this thesis is primarily concerned with the aspects of heat loss. Acomprehensive literature review on current ECMO technologies revealed a ratherstagnant progression in the evolution of heat exchangers, still employing legacycomponents dating back to the 1957’s. Moreover, most heat-exchange technologiestoday rely heavily on external power supplies which limits their use in energy-poorenvironments. For this reason, two novel solutions for thermal control were proposed,one focusing solely on traditional heat-exchange aspects for conventional hospitalbased ECMO therapy and the second a solution for energy poor transport settings.Materials and MethodsBoth heat exchanger concepts that were developed within this project progressedindividually, based on their underlying proposed applications.Heat exchanger concept 1 (for conventional ECMO): First, design requirements were established based on desired goals and shortcomings of current heatexchangers. These requirements set the boundaries and formed ideas that were evaluated, refined, and ultimately expressed in form of a finalised CAD drawing. Thedrawing and the underlying physical effects were modelled and optimised using acomputational simulation software in order to minimise time to deploy. Temperaturecontrollers were also designed within the computational domain and the completed,integrated model was simulated and validated with physical laboratory data. Aftersuccessful validation, our virtual model was manufactured and tested under nearclinical conditions.Heat Exchanger concept 2 (for in-transit ECMO): Similar to the previousstrategy, design requirements were established based on expressed clinical aims andimplemented in prototype technical drawings. These were used for manufacturing ofthe device and extensively tested under near-clinical conditions.ResultsThis project has produced two miniaturised medical prototypes for thermal management for very distinct ECMO circumstances; one for conventional ECMO and onefor in-transit ECMO. Both devices were computationally and physically tested andthe results indicated good agreement with set requirements. Limitations were foundwith heat exchanger concept 1 during the experimentation phase but were remediedby re-design and further development. A second experiment confirmed efficacylevels that achieved satisfactory results. Heat exchanger concept 2 demonstratedcapabilities of adding heat to the system under various ambient conditions andthereby slowing the rate of heat loss from the patient-ECMO system. Supplementarytest results indicated the potential for even further reducing the rate of heat losswith the usage of additional low-cost equipment. Through this project, we were ableto demonstrate a new direction for thermal management within portable and fixedECMO settings.This work includes the following:• Design of a novel heat exchanger model with the use of computational simulationsoftware.• Development of a novel and compact heat exchanger for conventional ECMOthat does not rely on water supply.• Development of a novel heat exchanger for mobile ECMO applications that isable to significantly reduce heat loss independent of mains or water supply.• Demonstrate high accuracy in model correlation between virtual and physicalresults.
- Resource Type
- DOI
- Date Created
- 2016
- Former identifier
- 9912537085602996
- Embargo Note
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File | 2021-07-02 | Privado |