Flow characterisation of drainage cannulae and centrifugal pumps used in extracorporeal membrane oxygenation: an experimental investigation

Abstract: Extracorporeal membrane oxygenation (ECMO) is a life-saving treatment for acute respiratory and/or circulatory failure. Typically driven by a centrifugal pump, blood is drained from the patient via one drainage cannula, oxygenated by a membrane lung and returned to the patient via the return cannula. Although lifesaving, ECMO is associated with thromboembolic and haemolytic complications in part related to the mechanical stresses experienced by blood in the ECMO circuit. This thesis focuses on the fluid dynamics of ECMO pumps and cannulae with the aim to improve the fundamental understanding of flow structures and overall performance of the respective components during different operating conditions. Experimental studies were conducted with particle image velocimetry (cannula flows) and high speed video recordings (pump characterisation, complex geometry). The dynamics of an isolated drainage cannula placed in a glasstube with dimensions similar to the inferior vena cava were studied considering two different cannula tip designs. Seven centrifugal pumps were investigated to evaluate pump mechanical performance and the development, for low flow rates, of backflow at the pump inlet. The dynamics leading to backflow was investigated together with numerical simulations. The results showed higher shear stress levels in a blunt cannula compared to a lighthouse tip cannula. The latter drained the highest volume fraction through the most proximal side-holes and not the tip. Cannula position relative to the wall did not alter these results. In pumps with a shroud over the impeller blades stable recirculation zones were observed on the sides of the pump inlet. These recirculating regions were formed by vortical structures detaching from the peripheral (suction) side of impeller blades and migrating over the shroud towards the pump inlet. This work increases the fluid dynamical understanding of centrifugal pumps and cannulae used for ECMO. In particular, data on detailed design features influencing inherent pump recirculation are revealed which may impact futurepump designs. Such changes have the potential to significantly reduce patient complications.