The effects of pressure and flow on hemolysis caused by Bio-Medicus centrifugal pumps and roller pumps

Tamari, Yehuda; Lee-Sensiba, Kerri; Leonard, Edward F.; Parnell, Vincent; Tortólani, Anthony J.

doi:10.1016/s0022-5223(19)33970-4

Cited by 50 publications

(28 citation statements)

References 8 publications

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“…the effect of increase in RPM on hemolysis is smaller with ClE3 than with the BP-80. RPM is directly related to shear stress, which causes hemolysis (15)(16)(17). Higher RPM causes higher shear rate, resulting in more hemolysis.…”

Section: Discussionmentioning

confidence: 99%

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Hemolytic Characteristics of a Pivot Bearing Supported Gyro Centrifugal Pump (C1E3) Simulating Various Clinical Applications

et al. 1996

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Centrifugal blood pumps are playing a key role in circulatory mechanical assist systems including cardiopulmonary bypass (CPB), right and left ventricular assist devices (RVAD and LVAD), percutaneous cardiopulmonary support (PCPS), and extracorporeal membrane oxygenation (ECMO). Each of these circulatory assist systems requires specific flow and pressure conditions. In vitro hemolysis tests were performed using five compact mock loops with flow and pressure set equivalent to clinical conditions. These studies determined the hemolytic characteristics and clinical applicability of the pivot bearing-supported Gyro centrifugal pump with an eccentric port (C1E3) compared with the Bio-Medicus pump (BP-80). Normalized index of hemolysis (NIH) values of the C1E3 were less than those of the BP-80 under all conditions; in particular, they were significantly less in the CPB, LVAD, and RVAD conditions. In addition, linear correlation was observed between NIH values, rotational pump speed (RPM), total pressure head (delta P), and flow rate (Q) with both the C1E3 and BP-80: NIH = a(RPM/Q) + b, NIH = c(delta P/Q) + d. However, the slopes (a and c) of these equations were smaller with the C1E3 than those with the BP-80, which suggests that the C1E3 has decreased hemolytic characteristics when increasing the RPM and delta P. In other words, the increase of RPM and delta P results in less shear stress with the C1E3 than with the BP-80. One cause of these decreased hemolytic characteristics of the C1E3 is thought to be less pump power loss against an increase of RPM and delta P than with the BP-80. Furthermore, the average exposure time is shorter with the C1E3 than with the BP-80 because the priming volume of the C1E3 (30 ml) is smaller than that of the BP-80 (80 ml). From the point of both shear stress and exposure time, the C1E3 has less hemolytic features than the BP-80.

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Section: Discussionmentioning

confidence: 99%

“…Another factor related to hemolysis is an exposure time (14)(15)(16)(17), which is defined as average exposure time (s) equals volume/flow. Because the priming volume of the C1E3 (30 mi) is smaller than that of the BP-80 (80 mi), the average exposure time with the ClE3 is shorter than that with the BP-80.…”

Section: Discussionmentioning

confidence: 99%

Hemolytic Characteristics of a Pivot Bearing Supported Gyro Centrifugal Pump (C1E3) Simulating Various Clinical Applications

et al. 1996

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“…In extracorporeal circulation, destruction of blood cells caused by factors such as continuous mechanical stress is a continuing problem that has attracted much attention (Blackshear and Forstrom, 1973;Nerem, 1981;Tillman et al, 1984;Wurzinger et al, 1986;Pohl et al, 1998;Steines et al, 1999;Affeld et al, 1998Affeld et al, , 1997Mizuguchi et al, 1994;Hashimoto, 1989) and it is necessary to prevent such erythrocyte damage or hemolysis. A number of studies rely on in vitro testing of blood hemolysis using animal blood in various simulated circulation environments (Kawahito and Nosé, 1997;Schima et al, 1993;Mathews and Sistino, 2001;Yasuda et al, 2001;Kawahito et al, 2001;Tamari et al, 1993). However, there are remarkable differences in the properties of resistance to hemolysis between animal and human blood under various physiologic conditions.…”

Section: Introductionmentioning

confidence: 99%

Trauma to erythrocytes induced by long term in vitro pumping using a roller pump

Ding

Zhang³

et al. 2007

Cell Biology International

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The objective of this study is to investigate the impact of trauma on erythrocyte caused by long term in vitro pumping using roller pump. Ten bags of human blood (400 ml each) were provided by a local blood bank and they were divided into two groups with five bags in each group. Each blood bag was subject to pumping in a closed circuit, which was composed of silica gel tubes and a roller pump. Polystan and COBE pumps were used for the two groups, respectively. The blood was pumped for 16 h in vitro. Free hemoglobin (FHb), platelets (PLT), erythrocyte fragility (EF), and morphological analysis of erythrocytes observed under scanning electron microscope were measured to evaluate the impact of trauma on erythrocytes. A small amount of blood was collected for analysis before pumping, at the end of the 4th hour and then every 2 h till the end of the 16th hour. Some blood samples were also collected for electron microscope scanning before pumping and every 4 h during pumping. It was found that FHb and PLT linearly increased with the pumping time. There was a significant correlation between the two parameters (r=0.7745, p<0.001). The hemolysis indexes of the two groups were 0.296 and 0.3993 mg/L/h, respectively, with no significant difference. During the pumping process, EF changed slightly. The observation of scanning electron microscopy showed various deformed erythrocytes after pumping, including the distortion of cell membrane and the appearance of echinocytes, which increased with pumping time. This study demonstrated that long term pumping using roller pump not only caused the immediate rupture of red blood cells, i.e. the immediate hemolysis, but also caused sub-trauma to a large number of erythrocytes, which led to the delayed hemolysis. The change of erythrocyte morphology was the basis of the delayed hemolysis.

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“…This observation is consistent with other studies showing that higher pump speeds are more likely to cause hemolysis. 19 Other risks of adding an HE in the nonheparinized VVB include the potential for clot formation in the circuit. We did not specifically examine the circuits for coagulation.…”

Section: Neelakanta Et Almentioning

confidence: 99%

Efficacy and safety of heat exchanger added to venovenous bypass circuit during orthotopic liver transplantation

et al. 1998

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Hypothermia during orthotopic liver transplantation (OLT) is common despite measures to prevent this complication. We retrospectively analyzed two groups of patients; those managed with (n ‫؍‬ 113) or without (n ‫؍‬ 109) a heat exchanger (HE) incorporated in the venovenous bypass (VVB) circuit to test the hypothesis that normothermia before liver reperfusion minimizes hypotension during reperfusion and decreases neohepatic transfusion requirements. Use of the HE resulted in significantly warmer patients during reperfusion and at the end of surgery (P F .001). An increase in neohepatic transfusion requirement was observed in patients with HE use: packed red blood cells, 4 ؎ 4 versus 3 ؎ 3 units; fresh-frozen plasma, 5 ؎ 5 versus 4 ؎ 4 units; platelets, 8 ؎ 8 versus 6 ؎ 7 units; and cryoprecipitate, 5 ؎ 7 versus 3 ؎ 5 units. There was no difference between the two groups in the untoward hemodynamic events during reperfusion of the liver (P ‫؍‬ .31). We conclude that during OLT, the use of an HE in a nonheparinized VVB circuit helps maintain normothermia. Our limited experience suggests that its use is safe but does not improve hemodynamic stability during reperfusion or decrease blood loss during the neohepatic period.

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The effects of pressure and flow on hemolysis caused by Bio-Medicus centrifugal pumps and roller pumps

Cited by 50 publications

References 8 publications

Hemolytic Characteristics of a Pivot Bearing Supported Gyro Centrifugal Pump (C1E3) Simulating Various Clinical Applications

Hemolytic Characteristics of a Pivot Bearing Supported Gyro Centrifugal Pump (C1E3) Simulating Various Clinical Applications

Trauma to erythrocytes induced by long term in vitro pumping using a roller pump

Efficacy and safety of heat exchanger added to venovenous bypass circuit during orthotopic liver transplantation

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