Blood warming, pump heating and haemolysis in low-flow extracorporeal life support; an in vitro study using freshly donated human blood

Low-flow extracorporeal life support can be used for cardiopulmonary support of paediatric and neonatal patients and is also emerging as a therapy for patients suffering from exacerbation of chronic obstructive pulmonary disease. However, pump heating and haemolysis have proven to negatively affect the system and outcome. This in vitro study aimed at gaining insight into blood warming, pump heating and haemolysis related to the performance of a new low-flow centrifugal pump. Pump performance in the 400-1,500 ml/min flow range was modulated using small-sized dual-lumen catheters and freshly donated human blood. Measurements included plasma free haemoglobin, blood temperature, pump speed, pump pressure, blood flow and thermographic imaging. Blood warming (ΔTmax=0.5°C) had no relationship with pump performance or haemolysis (R2max=0.05). Pump performance-related parameters revealed no relevant relationships with haemolysis (R2max=0.36). Thermography showed no relevant heat zones in the pump (Tmax=36°C). Concerning blood warming, pump heating and haemolysis, we deem the centrifugal pump applicable for low-flow extracorporeal circulation.

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Potential Danger of Pre-Pump Clamping on Negative Pressure-Associated Gaseous Microemboli Generation During Extracorporeal Life Support-An In Vitro Study

Artificial Organs ◽

10.1111/aor.12540 ◽

2015 ◽

Vol 40 (1) ◽

pp. 89-94 ◽

Cited By ~ 9

Author(s):

Shigang Wang ◽

Brian J. Chin ◽

Frank Gentile ◽

Allen R. Kunselman ◽

David Palanzo ◽

...

Keyword(s):

Negative Pressure ◽

Life Support ◽

Extracorporeal Life Support ◽

In Vitro Study ◽

Vitro Study ◽

Potential Danger

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Insensible Water Loss During Extracorporeal Life Support: an In Vitro Study † 976

Pediatric Research ◽

10.1203/00006450-199804001-00997 ◽

1998 ◽

Vol 43 ◽

pp. 168-168

Author(s):

Teresa Camacho ◽

Karl Hultquist ◽

Gary Nelson ◽

Bala R Totapally ◽

Damoon Eawaz ◽

...

Keyword(s):

Water Loss ◽

Life Support ◽

Extracorporeal Life Support ◽

In Vitro Study ◽

Vitro Study

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Study of the Effect of Magnetic Microspheres on Some Biophysical Parameters of Human Blood (In vitro Study)

Journal of Biotechnology & Biomaterials ◽

10.4172/2155-952x.1000135 ◽

2012 ◽

Vol 02 (03) ◽

Author(s):

Abdelrahman T Hereba

Keyword(s):

Human Blood ◽

In Vitro Study ◽

Vitro Study ◽

Magnetic Microspheres ◽

Biophysical Parameters

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Blood Platelet Activation and Membrane Glycoprotein Changes during Extracorporeal Life Support (Ecls). In Vitro Studies

The International Journal of Artificial Organs ◽

10.1177/039139889501800604 ◽

1995 ◽

Vol 18 (6) ◽

pp. 315-321 ◽

Cited By ~ 16

Author(s):

K. Mellgren ◽

L.G. Friberg ◽

T. Hedner ◽

G. Mellgren ◽

H. Wadenvik

Keyword(s):

Centrifugal Pump ◽

Life Support ◽

Extracorporeal Life Support ◽

Membrane Receptors ◽

Receptor Protein ◽

Roller Pump ◽

Platelet Surface ◽

Continuous Increase ◽

Significant Difference

The aim of this study was to evaluate an in vitro model for investigation of platelet function parameters in an extracorporeal system. Two different perfusion pumps were compared, a roller pump (Polystan) and a centrifugal pump (Biomedicus). A continuous increase in glycoprotein (GP)1b-negative platelets was observed in both circuits. A marked increase of plasma β-thromboglobulin thromboglobulin concentration and a decrease of the intracellular pool of serotonin was observed, indicating a marked release of alpha as well as of dense granules. The plasma concentration of glycocalicin increased in parallel with a reduced platelet surface expression of GP1b, suggesting that the loss of GP1b is caused by proteolysis rather than by a downregulation of this receptor protein. It is concluded that ECLS results in a pronounced platelet degranulation and causes changes of important membrane receptors which might explain some of the bleeding problems observed in patients treated with ECLS. No significant difference was noted between the roller pump and the centrifugal pump. Trial of strategies, e.g. protease inhibitors and nitric oxide to revert this untoward effect of ECLS are highly warranted.

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