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Hemolysis at low blood flow rates: in-vitro and in-silico evaluation of a centrifugal blood pump

Journal of Translational Medicine, Ausgabe 2021

Introduction

The use of extracorporeal membrane oxygenation (ECMO) in adult patients has been increasing rapidly in recent years [ 1]. ECMO therapy has become an established alternative as a rescue therapy in the treatment of severe forms of the acute respiratory distress syndrome (ARDS) with promising case series of extracorporeal CO 2 removal (ECCO 2R) in chronic obstructive pulmonary disease (COPD) [ 2– 4]. ECMO use in neonatal or pediatric patients, or the use for ECCO 2R, were considered the key low-flow applications in this study [ 5]. The use of ECMO in children with a weight below 10 kg increased on average by 2.2 % per year between 2011 and 2016. The predominant use of roller pumps switched to centrifugal pumps during this time period [ 6].

Centrifugal blood pumps as central elements of ECMO therapy provide good results in the high-flow operating ranges of 4 L/min–8 L/min of blood flow. However, during low-flow applications, i.e. neonatal or pediatric ECMO or ECCO 2R, the operating ranges are markedly lower at 0.5 L/min–2 L/min. These low-flow operating points contribute to adverse events such as increased hemolysis, platelet activation and bleeding complications [ 7, 8]. Furthermore, this may be a particularly important issue in vulnerable pediatric patients, where blood trauma should be carefully avoided [ 6, 9– 14].

Fortsetzung: https://www.springermedizin.de/hemolysis-at-low-blood-flow-rates-in-vitro-and-in-silico-evaluat/18735404?searchResult=3.Medizintechnik&searchBackButton=true&fulltextView=true&abEvent=detailLink

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