Experimental Study of Cavitation Phenomenon in a Centrifugal Blood Pump Induced by the Failure of Inlet Cannula

Cavitation of centrifugal blood pump is a serious problem accompany with the blocking failure of short inlet cannula. However, hardly any work has been seen in published literature on this complex cavitation phenomenon caused by the coupling effect of inlet cannula blocking and pumps suction. Even for cavitation studies on ordinary centrifugal pumps, similar researches on this issue are rare. In this paper, the roles of throttling, rotation speed and fluid viscosity on bubble inception and intensity in a centrifugal blood pump are studied, on the basis of experimental observations. An adjustable throttle valve installed just upstream blood pump inlet is used to simulate the throttling effect of the narrowed inlet cannula. The rotation speed is adjusted from 2 600 r/rain to 3 200 r/min. Glycerin water solutions are used to investigate the influences of kinetic viscosity. Bubbles are recorded with a high-speed video camera. Direct observation shows that different from cavitation in industrial centrifugal pumps, gas nuclei appears at the nearby of vane leading edges while throttling is light, then moves upstream to the joint position of inlet pipe and pump with the closing of the valve. It＇s found that the critical inlet pressure, obtained when bubbles are first observed, decreases linearly with viscosity and the slope is independent with rotation speeds; the critical inlet pressure and the inlet extreme pressure which is obtained when the throttle valve is nearly closed, fall linearly with rotation speed respectively and the relative pressure between them is independent with rotation speed and fluid viscosity. This paper studies experimentally on cavitation in centrifugal blood pump that caused by the failure of assembled short inlet cannula, which mav beneficial the desima of centrifugal blood Dumo with inlet cannula.

Numerical Simulation and Experimental Research on Passive Hydrodynamic Bearing in a Blood Pump

The current research of hydrodynamic bearing in blood pump mainly focuses on the bearing structure design.Compared with the typical plane slider bearing and Rayleigh step bearing,spiral groove bearing has excellent performance in load-carrying capacity.However,the load-carrying capacity would decrease significantly with increasing flow rate in conventional designs.In this paper,the special treatment is made to the upper spiral groove bearing to make sure that both the circulatory flowing and load-carrying capacity are high.Three-dimensional computational fluid dynamics(CFD) models in the space between rotor and shaft are developed by using FLUENT software.Effects of groove number,film height and groove depth on load-carrying capacity of the spiral groove bearings are investigated by orthogonal experiment design.The experimental results show that film height is the most remarkable factor to the load-carrying capacity.The variation tendency of load-carrying capacity reveals that the best combination of geometry is the one with groove number of 8,film height 0.03 mm and groove depth 0.08 mm.The velocity and pressure distributions in spiral groove bearings are also analyzed,and the analysis result shows that the distributions are in conformity with the design of the blood pump based on the principle of hydrodynamic bearing.The displacement of the rotor with the best combination parameters is tested by using laser displacement sensors,the testing result shows that the suspending performance is satisfactory both in axial and radial directions.This research proposes a bearing design method which has sufficient load-carrying capacity to support rotor as an effective passive hydrodynamic bearing.

Numerical Investigation of an Idealized Total Cavopulmonary Connection Physiology Assisted by the Axial Blood Pump With and Without Diffuser

In order to improve the surgical treatment of the congenital heart disease patient with single ventricle defect,two axial flow blood pumps,one with diffuser and the other without diffuser,were designed and virtually implanted into an idealized total cavopulmonary connection(TCPC)model to form two types of Pump-TCPC physiological structure.Computational fluid dynamics(CFD)simulationswere performed to analyze the variations of the hemodynamic characteristics,such as flow field,wall shear stress(WSS),oscillatory shear index(OSI),relative residence time(RRT),between the two Pump-TCPC models.Numerical results indicate that the Pump-TCPC with diffuser has better flow field stability,less damage on endothelial cell of vessel wall,and lower risk of vascular injury and thrombosis formation than that without diffuser.

Short term in vivo thrombosis evaluation of FW-Ⅱaxial blood pump for left ventricular assist

Objective To evaluate in vivo antithrombosis property of optimized FW-Ⅱaxial blood pump and provide evidence for future clinical use. Methods A left ventriclepump-descending aorta bypass model was established in five healthy sheep (60 70 kg) and the circulation ofthese sheep was assisted by FW-Ⅱaxial blood pump for 2 weeks. At preoperative and postoperative day 1,2,3,7。

Improved Hemolytic Performance of Blood Pump with Fluorine-Doped Hydrogenated Amorphous Carbon Coating

Fluorine-doped hydrogenated amorphous carbon (a-C:H:F) film was deposited on a flow-straightener, impeller and diffuser surface (SUS 304) of an enclosed-impeller type flow blood pump using the ionization deposition method with a source gas of C6F5H. The surface characteristics of the a-C:H:F film were examined using atomic force microscopy, X-ray photoelectron spectroscopy, and measurements of surface roughness, friction and surface potential. The a-C:H:F film tends to increase surface roughness and the negative surface charge. In addition, the surface energy and friction decrease with fluorine dopant in the a-C:H film. To estimate the hemolytic performance of a blood pump with the a-C:H:F film coating, the amount of hemolysis was measured using a mock circulatory system (in vitro test) with 500 mL of pig blood containing sodium citrate. In vitro test was conducted for 180 min with the blood flow and pump head maintained at 5 L/min and 100 mmHg, respectively. The a-C:H:F film coating reduced the amount of hemolysis and improved the hemolytic performance. Decreasing the surface energy and negative surface charge of the a-C:H:F film contributes to the improvement of the hemolytic performance. The a-C:H:F film coating is thus expected to be utilized in medical technology as a surface coating technology for artificial heart blood pumps.

The Characteristics of a Spiral Blood Pump

From 1997 to 1999, we developed a spiral blood pump. The spiral pump consists of a brushless DC motor, the pump housing, a magnetic-fluid seal, bearings and a spiral impeller. The maximum diameter of the impeller is 21.8 mm and minimum is 9.8 mm, the cone angle of the impeller threads is 41.8 degrees. The housing has a maximum diameter of 30 mm. The pump was made from Titanium alloy, the total volume of pump housing and motor was 76 ml and its weight 220g. Methods used: The hydrodynamic performance of the spiral pump was examined from 8 000 to 10 000rpm rotation speeds in a closed circuit loop. This circuit consists of a reservoir, a clamp, two pressure transducers, an electric-magnetic flow rate transducer and glycerin-water solution. The damage test to blood was studied in a smaller circuit loop, that used fresh sheep blood and polyvinyl chloride bag instead of the glycerin-water solution and the reservoir. In this test, the damage of the spiral pump was compared with an axial flow blood pump. Furthermore the simulated condition was 5.0 L/ min flow rate and 100 mmHg pressure. Summarize Results: 1. The flow rate was 4.0 L/min against 120 mmHg pressure when pump rotated 10000 rpm. So the hydrodynamic performance of the spiral blood pump was enough to meet a patient’s need when the blood pump was used as a left ventricular assistant device. 2. The NIH results of three gaps were 0.074±0.022g/100L,0.086±.026g/100L and 0.111±0.034g/100L(n=40) respectively. The best hemolysis result was been at the gap of 0.14 mm. 3. The NIH result of the spiral pump with 0.40gap was 0.111±0.034g/100L, n=40; and the axial flow pump was 0.131±0.030g/100L, n=40 respectively; The mean fibrinogen decreases of two pumps between half of an hour were 4.281±2.098mg/100L and 9.625±5.630mg/100L(n=40). So we can conclude that the damage of the spiral pump to blood was less than the axial flow pump. (P<0.05).

A New Magnetic Sealless Coupling Axial Flow Blood Pump

For rotating blood pump, the sealing problem is a very important one to solve. In this paper, it was introduced that we designed and made a small axial flow pump, applying the magnetic coupling method. The pump consisted of two pump housings, a brushless DC motor, an impeller with five wanes, a pair of magnetic discs, a spacer, an inlet and an outlet areas , bearings, a support frame, and etc. The pump is made of titanium and is 125 mm length, 147 ml volume, total 380g of weight. Performances of outputting, sealing, heat creating and damage to blood by the pump were investigated in vitro experiment. Results showed for external experiment that: (1)The pressure created by the pump was 90 mmHg, the flow rates were 1.2 L/min, 4 L/min, 5.9 L/min and 7.8 L/min correspondingly to 5000 rpm, 6000 rpm, 7000 rpm and 8000rpm rotation speeds. The hydrodynamic performance of the axial flow blood pump was enough to meet a patient need when the blood pump was used as a left ventricular assistant device. (2)The hemolysis test was studied by the normalized index of hemolysis(NIH). The NIH result of the axial flow pump was 0.08 g/100 L. (3)The outside temperature of the pump didnt change obviously in 120 hours of rotation, and the sealing function was very well.

DESIGN OF IMPLANTABLE AXIAL-FLOW BLOOD PUMP AND NUMERICAL STUDIES ON ITS PERFORMANCE

This article presents the design of a new implantable axial-flow blood pump. The special feature of the flow channel inside the blood pump is that the blood is driven by a big-small tandem impeller installed in the inner hole of the cylinder magnet of a brushless direct current motor. The inner hole makes the main flow channel possible, while the gap between the inner end of the stator and the outer end of the cylinder magnet gives the shape of the tributary flow channel. There is no motor magnet inside the main flow channel, therefore, more blood can pass through it. The gap of the tributary flow channel is very small, but the blood flow in it is not blocked. Thus, the efficiency is increased and the volume and weight of blood pump can be reduced greatly. The outer diameter, length and weight of the manufactured implantable axial-flow blood pump are 29.6 mm, 76 mm and 158 g, respectively. The impeller spins at the speed of 9000 rpm and can generate a pressure head of 100 mmHg and a flow rate of 8 L/rain. In an animal experiment, the blood pump has been successfully applied as a Ventricular Assist Device （VAD） in the chest of a small cow. Besides a mathematical model is established to simulate the flow inside an axial-flow blood pump of implantable VAD. The numerical studies on the performance of the implantable axial-flow blood pump are carried out by combining this mathematical model and the Fluent software. The numerical results agree well with those of experiments, with the maximum error less than 10%.

APPLICATIONS OF CFD TECHNIQUE IN THE DESIGN AND FLOW ANALYSIS OF IMPLANTABLE AXIAL FLOW BLOOD PUMP

Based on established numerical methods and hydrodynamic performance testing facilities,CFD technique are applied to improve the design of the implantable axial flow blood pump and the flow analysis.（1） Applying brushless machine magnet steel,reducing its thickness while increasing the length,the flow channel＇s cross-section is increased,with no space connection between the large and the small rotators,and with a cone transition segment from the bearing to the principal axis,the flow is made smoother.The rotating speed is lowered by 1000 rpm-1200 rpm under the same flow rate and pressure head,and thus the hemolysis can be avoided.（2） Different outlet stator guiding vanes are selected for the same blood pump for analyses of hydrodynamic performances and flow fields.An excellent design not only can regulate the rotating flow field into an axial one,reduce the circulation loss and improve the pump efficiency,but also can avoid backflow,vortex and secondary flow at the pump outlet,and thus the thrombus can be prevented.（3） The calf live tests show that some residual clots exist at the inner wall of the outlet connection bends,which are analyzed and explained by CFD techniques and the corresponding improvements are proposed.All results are verified by hydrodynamic performance tests and PIV flow field tests,and consistent conclusions are obtained.

The simulation of multiphase flow field in implantable blood pump and analysis of hemolytic capability

The numerical simulation of the axial flow impeller blood pump NIVADIII is carried out by using a CFD multiphase flow model. The hydrodynamic performance of the pump and the flow field in the pump are analyzed, and the shear stress distribution is obtained. A hemolytic prediction model based on the shear stress is built based on the calculation results, and it can be used for qua- ntitative predictions of the hemolytic behavior of a blood pump. Hemolysis tests in vitro were performed 6 times with fresh bovine blood. At each time, the flow of the pump NIVADIII is 5 L/min and the outflow tract pressure is 100 mmHg. According to the tests, the plasma free hemoglobin （FHB） content and the hematocrit （HCT） are measured after 0 s, 0.5 s, 1 s, 1.5 s 4 s. At the end of each experiment Normal Index of Hemolysis （NIH） of NIVADIII is calculated. The average of NIH is 0.0055 g/100L, almost identi- cal with that obtained from the hemolytic prediction model. This method can be applied in the selection stage of a blood pump.

Estimation of the turbulent viscous shear stress in a centrifugal rotary blood pump by the large eddy particle image velocimetry method

The non-physiologic turbulent flows in centrifugal rotary blood pumps (RBPs) may result in complications such as the hemolysis and the platelet activation. Recent researches suggest that the turbulent viscous dissipation in the smallest eddies is the main factor of the blood trauma caused by the turbulent flow. The turbulent viscous shear stress (TVSS) was taken as the realistic physical force acting on the cells. However, limited by the temporal and spatial resolutions of the instrumentation currently available, very limited studies are available for the TVSS in the RBPs. In this paper, the large eddy particle image velocimetry (PIV) method is used to estimate the turbulent dissipation rate in the sub-grid scale, to investigate the effect of the TVSS on the blood trauma. Detailed flow characteristics, such as the relative velocity vectors, the estimated TVSS levels and the Kolmogorov length scales, are analyzed in three impeller phases at three constant flow rates (3 L/min, 5 L/min and 7 L/min). Over the measures range in this study, the maximum TVSS in the investigated RBP is lower than the reported critical value of stress. This study demonstrates that the large eddy PIV method is effective to evaluate the flow-dependent force on the cells. On the other hand, it is found that the TVSS is highly dependent on the flow behavior. Under severe off-design conditions, the complex flow characteristics, such as the flow separation and the vortical structures, will increase the TVSS. Thus, in order to reduce the hemolysis in the RBPs, the flow disturbance, induced by the departure of the incidence angle, should be avoided during the design of the RBPs.

Recent advances in the application of computational fluid dynamics in the development of rotary blood pumps

In recent years,ventricular assist devices(VADs,also known as blood pumps)have gradually entered clinical practice and provide effective treatment for heart failure patients.However,adverse events related to mechanical blood damage in patients receiving the VAD treatment,were often reported and have become a major concern during the development of VADs,limiting their clinical and economic benefits.Compared with bench and in-vivo testing,computational fluid dynamics(CFD)is flexible and inexpensive,offering the possibility to predict hemodynamics and mechanical blood damage in a purely numerical manner.Thus,CFD has become an important tool for the design,optimization and evaluation of blood pumps.The stringent requirements of blood pumps require high fidelity simulations.Thus,this article reviews the current state of the art in high-fidelity methodologies for simulating blood flow and blood damage for the development and evaluation of rotary blood pumps;design and optimization methods of rotatory blood pumps using CFD,as well as future challenges.

Computational fluid dynamics analysis and experimental hemolytic performance of three clinical centrifugal blood pumps: Revolution, Rotaflow and CentriMag

Centrifugal blood pumps have become popular for adult extracorporeal membrane oxygenation(ECMO)due to their superior blood handling and reduced thrombosis risk featured by their secondary flow paths that avoid stagnant areas.However,the high rotational speed within a centrifugal blood pump can introduce high shear stress,causing a significant shear-induced hemolysis rate.The Revolution pump,the Rotaflow pump,and the CentriMag pump are three of the leading centrifugal blood pumps on the market.Although many experimental and computational studies have focused on evaluating the hydraulic and hemolytic performances of the Rotaflow and CentriMag pumps,there are few on the Revolution pump.Furthermore,a thorough direct comparison of these three pumps'flow characteristics and hemolysis is not available.In this study,we conducted a computational and experimental analysis to compare the hemolytic performances of the Revolution,Rotaflow,and CentriMag pumps operating under a clinically relevant condition,i.e.,the blood flow rate of 5 L/min and pump pressure head of 350 mmHg,for adult ECMO support.In silico simulations were used to characterize the shear stress distributions and predict the hemolysis index,while in vitro blood loop studies experimentally determined hemolysis performance.Comparative simulation results and experimental data demonstrated that the CentriMag pump caused the lowest hemolysis while the Revolution pump generated the highest hemolysis.

Particle Image Velocimetry Experimental and Computational Investigation of a Blood Pump

Blood pumps have been adopted to treat heart failure over the past decades.A novel blood pump adopting the ro-tor with splitter blades and tandem cascade stator was developed recently.A particle image velocimetry (PIV) experiment was carried out to verify the design of the blood pump based on computational fluid dynamics (CFD) and further analyze the flow properties in the rotor and stator.The original sized pump model with an acrylic housing and an experiment loop were constructed to perform the optical measurement.The PIV testing was car-ried out at the rotational speed of 6952±50 r/min with the flow rate of 3.1 l/min and at 8186±50 r/min with 3.5 l/min,respectively.The velocity and the Reynolds shear stress distributions were investigated by PIV and CFD,and the comparisons between them will be helpful for the future blood pump design.

Effect of ultraviolet blood irradiation and oxygenation on nerve function and function of the red blood cell membrane pump in patients with acute cerebral infarction

BACKGROUND： Ultraviolet blood irradiation and oxygenation （UBIO） has obtained better clinical effect in treating acute cerebral infarction, but the mechanism underlying this effect remains unclear. OBJECTIVE： To observe the effect of UBIO on the nerve function and activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase activities on the red blood cell （RBC） membrane of patients with acute cerebral infarction. DESIGN： A randomized and controlled study.SETTING： Department of Neurology, Xiangfan Central Hospital.PARTICIPANTS： From January 2000 to December 2001, excluding those above 70 years old, 58 cases of 700 patients with acute cerebral infarction admitted in the Department of Neurology, Xiangfan Central Hospital, were recruited and divided into two groups according to the random number table： UBIO treated group （n=28）, including 17 males and 11 females, aged 40-68 years; and control group （n=30）, including 20 males and 10 females, aged 44-69 years. All the patients agreed to participate in the therapeutic program and detected items. The general informations were comparable without obvious differences between the two groups （P 〉 0.05）.METHODS： ① The patients in both groups received routine treatments, besides, those in the UBIO treated group were given UBIO treatment by using the XL-200 type therapeutic apparatus produced in Shijiazhuang, whose ultraviolet wave was set at 253.7 nm with the energy density of 0.568 J/m^2 per second, UBIO treatment started from the second day after admission, once every other day, with a single course consisting of 5-7 treatments. ② In the UBIO treated group, the venous blood was sampled before and after the first, third and the completion of the treatment course respectively, the venous blood was taken at each corresponding time point in the control group. After centrifugation of the blood at 10 000 rounds per minute, the RBC membrane was separated and then the activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase were detected by means of phosphorus determination.③ The nerve function was scored before and after treatment in both groups with European stroke scale, which included 13 items, the total score was 0-100 points, the higher the score, the better the nerve function. MAIN OUTCOME MEASURES ：①Score of European stroke scale before and after treatment in both groups.② Comparison of the activities of K^＋-Na^＋-ATPase and Ca2^＋-Mg2^＋-ATPase on RBC membrane between the two groups before treatment and after the first, third and the completion of the treatment. RESULTS： All the 58 patients with cerebral infarction were involved in the analysis of results.① The score of European stroke scale had no obvious difference between the two groups [（49.31±11.48）, （50.58±12.63）, P 〉 0.05], and it was obviously higher in the UBIO treated group than in the control group after treatment [84.66±13.75）, （77.05±11.17）, P 〈 0.05].②The activity of K^＋-Na^＋-ATPase on RBC membrane in the UBIO treated group was significantly increased after the first and third treatment as compared with before treatment [（31.56±19.25）, （27.64±15.83）, （17.67±13.83）, P 〈 0.01], it was still higher after the completion of the treatment than before treatment without obvious difference [（20.86±14.53）, P 〉 0.05]. After the first and third treatment, it was obviously higher in the UBIO treated group than in the control group [19.31±11.88）, （17.44±10.42）, P 〈 0.01]. ③ In the UBIO treated group, Ca2^＋-Mg2^＋-ATPase activity on RBC membrane significantly increased after the first treatment and remained higher than the pre-treatment level throughout the treatment [（27.49±14.72）, （17.41±4.82）, P 〈 0.01]. The activity of Ca2^＋-Mg2^＋-ATPase on RBC membrane was markedly higher in the UBIO treated group than in the control group after after the first, third and the completion of treatment respectively [（24.83±12.88）, （17.70±5.69）; （28.08±13.44）, （16.32±5.29）; （17.42±6.04）, P〈 0.05-0.01]. CONCLUSION： The effect of UBIO treatment against acute cerebral infarction may be mediated by the increased K^＋-Na^＋ ATPase and Ca2^＋-Mg2^＋-ATPase activities on RBC membrane, which enhances the RBC transformation ability so as to lower RBC aggregation and correct high blood viscosity.

Epidural Blood Patch for Treatment of Postdural Puncture Headache in a Patient with Spinal Fusion and Recent Implantation of Intrathecal Pain Pump

We present an interesting case report of a 49-year-old female who presented with symptoms of post-dural puncture headache following implantation of an intrathecal pain pump. Her history was complicated by previous multi-level spinal fusion with hardware. The patient was evaluated and felt to be a candidate for epidural blood patch, which she elected to proceed with. Under fluoroscopic guidance epidural blood patch was successfully performed. Immediately following the procedure the patient noted significant improvement in the headache and six hours following the procedure was headache free and remained so at follow up three weeks later.

Subdural Hematoma and Postdural Puncture Headache from Intrathecal Pump Placement Resolved with Lumbar Epidural Blood Patch

Intrathecal drug delivery systems are commonly used in the management of chronic pain, cancer pain and neuromuscular disorders with muscle spasticity. The complications associated with in-trathecal pump placement include persistent cerebrospinal fluid (CSF) leak, hygroma, meningitis, and granuloma formation. A severe persistent CSF leak may cause postdural puncture headache along with acute intracranial subdural hematoma, which can be potentially life threatening. Surgical exploration with dural repair is required to treat this severe complication when conservative treatments fail. We present a case report of severe persistent CSF leak after intrathecal pump revision that resulted in a subdural hematoma and postdural puncture headache. In this case, an epidural blood patch was performed using epidural catheter under fluoroscopic guidance to target the site of CSF leak and to avoid damaging the intrathecal catheter. This patient’s headache was resolved and intrathecal catheter remained intact after this blood patch.

主动脉穿刺型轴流血泵折边结构叶轮的数值模拟及溶血分析

为解决血泵因叶顶间隙泄漏而造成溶血和血栓等问题,引入了一种折边不等间距叶轮,采用计算流体力学(computational fluid dynamics, CFD)进行内部流场的数值模拟,并与非折边不等间距叶轮及折边等间距叶轮进行对比分析,研究了它们的内流场动力学特性和血液相容性.结果表明:折边叶片结构血泵避免了叶顶间隙泄漏流的产生,同时折边不等间距叶轮减少了叶轮入口和出口处的回流和涡流,流道内整体切应力低于其他2种叶轮;3种叶轮的溶血指数HI均满足血泵的溶血设计指标,其中,折边不等间距叶轮血泵壁面切应力在0~150 Pa的占比达96.84%,曝光时间相对集中且满足人工血泵设计要求,溶血指数较非折边不等间距叶轮血泵下降了3.50%,较折边等间距叶轮血泵下降了12.50%,溶血性能最优.提出的折边不等间距叶轮血泵可有效降低红细胞破损概率,减少溶血和血栓的发生,可为轴流血泵的结构设计和优化提供一定参考.

胰岛素不同注射方式对糖尿病血糖控制效果的影响研究

目的分析胰岛素不同注射方式对2型糖尿病患者血糖控制情况的影响。方法选取2021年9月—2023年9月安溪县医院收治的186例2型糖尿病患者为研究对象,利用最新统计学软件生成随机序列后将其分为对照组、观察组,各93例。两组研究对象均选用门冬胰岛素治疗,其中对照组注射方式为多次胰岛素皮下注射,观察组注射方式为胰岛素泵持续泵注。对比两组血糖控制情况、胰岛素使用剂量、血糖达标情况以及胰岛β细胞功能。结果观察组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均低于对照组,差异有统计学意义(P均<0.05)。观察组平均每天胰岛素使用量低于对照组,血糖达标时间短于对照组,且在达标即刻使用的胰岛素总量少于对照组,差异有统计学意义(P均<0.05)。观察组胰岛β细胞功能优于对照组,差异有统计学意义(P<0.05)。结论对于2型糖尿病患者,采用胰岛素泵持续泵注这一注射方式,有利于改善血糖、血压及血脂水平,同时改善胰岛β细胞功能,且使用胰岛素剂量更低,能够更快速地达到控糖标准。