Flow dynamics of peripheral venous catheters during extracorporeal membrane oxygenation with a centrifugal pump

Rk, Wenger; Je, Bavaria; Mb, Ratcliffe; Bogen, Daniel K.; Lh, Edmunds

doi:10.1016/s0022-5223(19)35249-3

Cited by 25 publications

(17 citation statements)

References 14 publications

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“…In order to compensate the reduced venous return, the insertion of the CF pump in the venous line was proposed. Bench tests demonstrated that the active¯ow is not in¯uenced by the ®lling pressure as long as the tip of the cannula is maintained into a large reservoir such as the right atrium [11]. In these cases situations, the risk of atrial wall collapsing is very unlikely even with the negative pressure induced around the cannula by the CF pump.…”

Section: Discussionmentioning

confidence: 99%

“…In our patients, the drainage of the IVC was performed through a peripheral approach whereas the SVC was drained with a second cannula placed into the mini-thoracotomy. In vitro analysis demonstrated that the drainage through a cannula positioned into a collapsible tube such as the vena cava is highly dependent on the ®lling pressure [11]. It is, in addition, signi®cantly in¯uenced by the ratio between the outer diameter of the cannula and the diameter of the drained cavity because; whatever the size of the cannula, the¯ow is reduced when this ratio is higher than 50% [11].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Augmented venous return for minimally invasive open heart surgery with selective caval cannulation

Jochheim¹,

Tevaearai²,

Horisberger³

et al. 1999

European Journal of Cardio-Thoracic Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Augmented venous return for minimally invasive open heart surgery with selective caval cannulation

Jochheim¹,

Tevaearai²,

Horisberger³

et al. 1999

European Journal of Cardio-Thoracic Surgery

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“…Wenger and coworkers reported that the maximum flow was seen when the diameter ratio between the IVC and the cannula was 0.56. When the ratio exceeded 0.56, the IVC was rapidly collapsed, and the drainage flow was decreased (2). Sinard and coworkers, and Montoya and associates also showed that the maximum flow decreased when the diameter ratio exceeded 0.5.…”

Section: Effect Of Cannula Positionmentioning

confidence: 96%

An In Vitro Evaluation of Venous Cannula in a Simulated Partial (Femoro‐Femoral) Cardiopulmonary Bypass Circuit

Kugai¹,

Koja²,

Kusaba³

1995

Artificial Organs

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We designed a study to evaluate three factors (siphon gradient [PH], the right atrial pressure [RAP], and the inferior vena caval flow [IVCF]) to be optimized to maximize the venous drainage flow (DF) during partial cardiopulmonary bypass using eight venous cannulas of three different types and an original model circuit. The relationship between venous DF and the three factors is indicated by the multiple regression equation DF2 = alpha PH + beta RAP + gamma IVCF2 + C, where alpha, beta, and gamma are regression estimates and C is a constant. Multiple regression analysis results showed that DF was positively correlated with PH and RAP and negatively correlated with IVCF. A long cannula with 12 side holes and 60 cm long was considered to be useful to yield the optimal venous drainage flow under the condition of maintenance of the flow balance (DF and ICVF) and the pressure balance (RAP and IVCP) at the zero point. Moreover, this model may allow extensive research in flow dynamics of venous cannula without involving human subjects.

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“…7 We found that the configuration with a nominal diameter of 36 F, which can be inserted through a 24 F access orifice provides full flow at negative pressure loads of less than 50 mm Hg. 6,7 However, current clinical practice in MICS is to run for venous drainage augmentations of up to 80 mm Hg, [2][3][4]11,12 and under these conditions, it seemed worthwhile to design a smaller virtually wall-less cannula, taking advantage of the higher augmentation used in clinical routine for this setting. Following positive results during in silico and in vitro evaluation of this new thinner 24 F ST design with increased hoop strength, 13,14 the present study was realized for in vivo validation and confirmed the benefit of this approach.…”

Section: Discussionmentioning

confidence: 99%

New, Virtually Wall-Less Cannulas Designed for Augmented Venous Drainage in Minimally Invasive Cardiac Surgery

Segesser

Berdajs

Abdel-Sayed

et al. 2016

Innovations�(Phila)

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Objective Inadequate venous drainage during minimally invasive cardiac surgery becomes most evident when the blood trapped in the pulmonary circulation floods the surgical field. The present study was designed to assess the in vivo performance of new, thinner, virtually wall-less, venous cannulas designed for augmented venous drainage in comparison to traditional thin-wall cannulas. Methods Remote cannulation was realized in 5 bovine experiments (74.0 ± 2.4 kg) with percutaneous venous access over the wire, serial dilation up to 18 F and insertion of either traditional 19 F thin wall, wire-wound cannulas, or through the same access channel, new, thinner, virtually wall-less, braided cannulas designed for augmented venous drainage. A standard minimal extracorporeal circuit set with a centrifugal pump and a hollow fiber membrane oxygenator, but no inline reservoir was used. One hundred fifty pairs of pump-flow and required pump inlet pressure values were recorded with calibrated pressure transducers and a flowmeter calibrated by a volumetric tank and timer at increasing pump speed from 1500 RPM to 3500 RPM (500-RPM increments). Results Pump flow accounted for 1.73 ± 0.85 l/min for wall-less versus 1.17 ± 0.45 l/min for thin wall at 1500 RPM, 3.91 ± 0.86 versus 3.23 ± 0.66 at 2500 RPM, 5.82 ± 1.05 versus 4.96 ± 0.81 at 3500 RPM. Pump inlet pressure accounted for 9.6 ± 9.7 mm Hg versus 4.2 ± 18.8 mm Hg for 1500 RPM, −42.4 ± 26.7 versus −123 ± 51.1 at 2500 RPM, and −126.7 ± 55.3 versus −313 ±116.7 for 3500 RPM. Conclusions At the well-accepted pump inlet pressure of −80 mm Hg, the new, thinner, virtually wall-less, braided cannulas provide unmatched venous drainage in vivo. Early clinical analyses have confirmed these findings.

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Flow dynamics of peripheral venous catheters during extracorporeal membrane oxygenation with a centrifugal pump

Cited by 25 publications

References 14 publications

Augmented venous return for minimally invasive open heart surgery with selective caval cannulation

Augmented venous return for minimally invasive open heart surgery with selective caval cannulation

An In Vitro Evaluation of Venous Cannula in a Simulated Partial (Femoro‐Femoral) Cardiopulmonary Bypass Circuit

New, Virtually Wall-Less Cannulas Designed for Augmented Venous Drainage in Minimally Invasive Cardiac Surgery

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