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Computational evaluation of the thrombogenic potential of a hollow-fiber oxygenator with integrated heat exchanger during extracorporeal circulation

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Abstract

The onset of thromboembolic phenomena in blood oxygenators, even in the presence of adequate anticoagulant strategies, is a relevant concern during extracorporeal circulation (ECC). For this reason, the evaluation of the thrombogenic potential associated with extracorporeal membrane oxygenators should play a critical role into the preclinical design process of these devices. This study extends the use of computational fluid dynamics simulations to guide the hemodynamic design optimization of oxygenators and evaluate their thrombogenic potential during ECC. The computational analysis accounted for both macro- (i.e., vortex formation) and micro-scale (i.e., flow-induced platelet activation) phenomena affecting the performances of a hollow-fiber membrane oxygenator with integrated heat exchanger. A multiscale Lagrangian approach was adopted to infer the trajectory and loading history experienced by platelet-like particles in the entire device and in a repetitive subunit of the fiber bundles. The loading history was incorporated into a damage accumulation model in order to estimate the platelet activation state (PAS) associated with repeated passes of the blood within the device. Our results highlighted the presence of blood stagnation areas in the inlet section that significantly increased the platelet activation levels in particles remaining trapped in this region. The order of magnitude of PAS in the device was the same as the one calculated for the components of the ECC tubing system, chosen as a term of comparison for their extensive diffusion. Interpolating the mean PAS values with respect to the number of passes, we obtained a straightforward prediction of the thrombogenic potential as a function of the duration of ECC.

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Abbreviations

BRD:

Blood recirculating device

CFD:

Computational fluid dynamics

DPM:

Discrete phase modeling

ECC:

Extracorporeal circulation

HE:

Heat exchanger

OXY:

Oxygenator

PAS:

Platelet activity state

SA:

Stress accumulation

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Authors and Affiliations

  1. Department of Biomedical Engineering, Politecnico di Milano, Milano, Italy

    Alessandra Pelosi, Marco Stevanella, Gianfranco B. Fiore & Alberto Redaelli

  2. Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA

    Jawaad Sheriff & Danny Bluestein

Authors
  1. Alessandra Pelosi
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  2. Jawaad Sheriff
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  3. Marco Stevanella
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  4. Gianfranco B. Fiore
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  5. Danny Bluestein
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  6. Alberto Redaelli
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Correspondence to Alessandra Pelosi.

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Pelosi, A., Sheriff, J., Stevanella, M. et al. Computational evaluation of the thrombogenic potential of a hollow-fiber oxygenator with integrated heat exchanger during extracorporeal circulation. Biomech Model Mechanobiol 13, 349–361 (2014). https://doi.org/10.1007/s10237-012-0445-0

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  • DOI: https://doi.org/10.1007/s10237-012-0445-0

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