Pressure and flow properties of cannulae for extracorporeal membrane oxygenation I: return (arterial) cannulae

Lars Mikael Broman, Lisa Prahl Wittberg, C. Jerker Westlund, Martijn Gilbers, Luisa Perry da Câmara, Justyna Swol, Fabio S. Taccone, Maximilian V. Malfertheiner, Matteo Di Nardo, Leen Vercaemst, Nicholas A. Barrett, Federico Pappalardo, Jan Belohlavek, Thomas Müller, Mirko Belliato, Roberto Lorusso

Research output: Contribution to journalArticle

Abstract

Adequate extracorporeal membrane oxygenation support in the adult requires cannulae permitting blood flows up to 6-8 L/minute. In accordance with Poiseuille’s law, flow is proportional to the fourth power of cannula inner diameter and inversely proportional to its length. Poiseuille’s law can be applied to obtain the pressure drop of an incompressible, Newtonian fluid (such as water) flowing in a cylindrical tube. However, as blood is a pseudoplastic non-Newtonian fluid, the validity of Poiseuille’s law is questionable for prediction of cannula properties in clinical practice. Pressure–flow charts with non-Newtonian fluids, such as blood, are typically not provided by the manufacturers. A standardized laboratory test of return (arterial) cannulae for extracorporeal membrane oxygenation was performed. The aim was to determine pressure–flow data with human whole blood in addition to manufacturers’ water tests to facilitate an appropriate choice of cannula for the desired flow range. In total, 14 cannulae from three manufacturers were tested. Data concerning design, characteristics, and performance were graphically presented for each tested cannula. Measured blood flows were in most cases 3-21% lower than those provided by manufacturers. This was most pronounced in the narrow cannulae (15-17 Fr) where the reduction ranged from 27% to 40% at low flows and 5-15% in the upper flow range. These differences were less apparent with increasing cannula diameter. There was a marked disparity between manufacturers. Based on the measured results, testing of cannulae including whole blood flows in a standardized bench test would be recommended.

Original languageEnglish
Pages (from-to)58-64
Number of pages7
JournalPerfusion (United Kingdom)
Volume34
Issue number1_suppl
DOIs
Publication statusPublished - Apr 1 2019

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Keywords

  • arterial
  • blood
  • cannula
  • extracorporeal life support
  • extracorporeal membrane oxygenation
  • pressure flow
  • return
  • water

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Safety Research
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Broman, L. M., Prahl Wittberg, L., Westlund, C. J., Gilbers, M., Perry da Câmara, L., Swol, J., Taccone, F. S., Malfertheiner, M. V., Di Nardo, M., Vercaemst, L., Barrett, N. A., Pappalardo, F., Belohlavek, J., Müller, T., Belliato, M., & Lorusso, R. (2019). Pressure and flow properties of cannulae for extracorporeal membrane oxygenation I: return (arterial) cannulae. Perfusion (United Kingdom), 34(1_suppl), 58-64. https://doi.org/10.1177/0267659119830521