Understanding Hemocompatibility in Rotary Blood Pumps
As a practitioner in the field of extracorporeal life support (ECLS), understanding the nuances of hemocompatibility in rotary blood pumps is crucial. The recent research titled Low-flow assessment of current ECMO/ECCO2R rotary blood pumps and the potential effect on hemocompatibility provides valuable insights into the challenges and considerations when using these devices at low blood flow rates.
Key Findings and Implications
The study highlights several key findings that practitioners should be aware of:
- Hydraulic Efficiency: Operating rotary blood pumps at blood flow rates below 1 L/min dramatically decreases hydraulic efficiency to 5-10%. This inefficiency can lead to increased internal recirculation and higher shear stress, which are detrimental to blood components.
- Shear Stress and Hemolysis: The research shows that lower blood flow rates result in multiple exposures to high shear stress, leading to a steep increase in hemolysis and destruction of platelets. This is particularly concerning for patients with acute respiratory distress syndrome (ARDS) or chronic obstructive pulmonary disease (COPD) undergoing ECCO2R.
- Recirculation Ratios: At low blood flow rates, the recirculation ratio increases significantly, with blood being recirculated multiple times within the pump before reaching the outlet. This repeated exposure exacerbates hemolysis and platelet damage.
Practical Recommendations
Based on these findings, practitioners are encouraged to:
- Exercise caution when operating rotary blood pumps at flow rates below 2 L/min. The increased risk of hemolysis and platelet destruction at these rates necessitates careful monitoring and management.
- Advocate for the development of dedicated blood pumps optimized for low blood flow rates (0.5-1.5 L/min) to improve hemocompatibility and patient outcomes.
- Consider the implications of shear stress and recirculation on patient safety and adjust clinical practices accordingly to mitigate adverse effects.
Encouraging Further Research
This study underscores the need for ongoing research into the design and operation of blood pumps used in ECCO2R and ECMO. Practitioners are encouraged to engage with the latest research, attend relevant conferences, and participate in clinical trials to stay informed about advancements in this field.
To read the original research paper, please follow this link: Low-flow assessment of current ECMO/ECCO2R rotary blood pumps and the potential effect on hemocompatibility.
