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Publications

Journal Article Ahead of print

PubMed: 42576280 DOI: 10.1177/02676591261476520

Pressure - flow measurements of pumps used in extracorporeal life support.

Perfusion

Authors: Federico Rorro, Lisa Prahl Wittberg, Fabio Silvio Taccone, Nicholas A Barrett, Maximilain V Malfertheiner, Matteo Di Nardo, Justyna Swol, Jan Belohlavek, Leen Vercaemst, Federico Pappalardo, Roberto Lorusso, Mirko Belliato, Lars Mikael Broman

Affiliations

  • FLOW, Department of Engineering Mechanics, Royal Institute of Technology (KTH), Stockholm, Sweden.
  • Department of Intensive Care, Hôpital Universitaire de Bruxelles (HUB), Université Libre de Bruxelles (ULB), Brussels, Belgium.
  • Department of Critical Care, Guy's and St Thomas' NHS Foundation Trust, London, UK.
  • Department of Surgery, Centre for Human & Applied Physiological Sciences, King's College London, London, UK.
  • Center for Pneumology, Caritas-Krankenhaus St.Maria, Donaustauf, Germany.
  • Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.
  • Pediatric Intensive Care Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
  • Department of Respiratory Medicine, Paracelsus Medical University, Nuremberg, Germany.
  • Second Department of Medicine-Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
  • Department of Cardiac Surgery, University Hospitals Leuven, Leuven, Belgium.
  • KORE University, Enna and Centro Cuore GB Morgagni, Catania, Italy.
  • Cardio-Thoracic Surgery Department, Maastricht University Medical Centre (MUMC) and Cardiovascular Research Institute Maastricht (CARIM), Maastricht, The Netherlands.
  • SCAR2-Anestesia e Terapia Intensiva Cardiotoracica, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
  • ECMO Centre Karolinska, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
  • Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.

Abstract

IntroductionThe blood pump is a central component of the extracorporeal life support (ECLS) circuit. Modern centrifugal and diagonal pumps are mainly used in preference to roller pumps. Compared to roller pumps, centrifugal and diagonal pumps offer lower priming volume, less hemolysis and enable miniaturization of circuits. Drawback is the open design promoting internal recirculation, which influences performance and, in few studies at low flow, may increase risk of coagulation activation and hemolysis. The aim of this work was to provide performance data on available pumps.MethodsManufacturers were asked to lend ECLS consoles and donate pump samples for the study. No financial support was accepted. Missing pumps were bought by the investigators. In a mock-loop, measurements of volume flow and pressures were performed. Pumps were assessed over the operating flow range stated by the manufacturer at different preloads and afterload levels.ResultsEight different ECLS pumps were tested, two available for pediatric use and six for adult use. Six pumps were centrifugal and two were of diagonal design. All were magnetically driven and three were magnetically levitated. Five had impellers with shrouded (covered) design. Water or water-glucose were used as a test fluid and choice of medium is herewith also discussed. Flow-pressure maps for each pump were generated over its operating range. As agreed with manufacturers, no direct comparisons between pumps were made.ConclusionsPerformance curves for blood pumps designed for ECLS use in children and adults were reported and important aspects of design features discussed to support clinicians.

MeSH

Research Design, Blood, Extracorporeal Circulation, Extracorporeal Membrane Oxygenation, Hemolysis