Journal article
Flow Monitoring of ECMO Circuit for Detecting Oxygenator Obstructions
Annals of biomedical engineering, Vol.49(12), pp.3636-3646
10/27/2021
DOI: 10.1007/s10439-021-02878-w
PMID: 34705123
Abstract
Oxygenator thrombosis during extracorporeal membrane oxygenation (ECMO), is a complication that necessitates component replacement. ECMO centers monitor clot burden by intermittent measurement of pressure drop across the oxygenator. An increase in pressure drop at a preset flow rate suggests an increase in resistance/clot formation within the oxygenator. This monitoring method comes with inherent disadvantages such as monitoring gaps, and increased risk of air embolism and infection. We explored utilizing flow measurement, which avoids such risks, as an indicator of ECMO circuit obstructions. The hypothesis that flow rate through a shunt tube in the circuit will increase as distal resistances in the circuit increases was tested. We experimentally simulated controlled levels of oxygenator obstructions using glass microspheres in an ex vivo veno-venous ECMO circuit and measured the change in shunt flow rate using over the tube ultra-sound flow probes. A mathematical model was also used to study the effect of distal resistances in the ECMO circuit on shunt flow. Results of both the mathematical model and the experiments showed a clear and measurable increase in shunt flow with increasing levels of oxygenator obstruction. Therefore, flow monitoring appears to be an effective non-contact and continuous method to monitor for obstruction during ECMO.
Details
- Title: Subtitle
- Flow Monitoring of ECMO Circuit for Detecting Oxygenator Obstructions
- Creators
- Srivats Sarathy - University of IowaJoseph W Turek - Duke UniversityJian Chu - Boston Children's HospitalAditya Badheka - Boston Children's HospitalMarco A Nino - University of IowaM. L Raghavan - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Annals of biomedical engineering, Vol.49(12), pp.3636-3646
- DOI
- 10.1007/s10439-021-02878-w
- PMID
- 34705123
- ISSN
- 0090-6964
- eISSN
- 1573-9686
- Grant note
- name: Office of the Vice President for Research, University of Iowa
- Language
- English
- Date published
- 10/27/2021
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Critical Care; Stead Family Department of Pediatrics
- Record Identifier
- 9984196980902771
Metrics
87 Record Views