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在患者特定的大动脉中对栓塞运输的心肺旁路参数的调查
Nafis M Arefin1, Bryan C Good2
1Department of Mechanical, Aerospace, and Biomedical Engineering, University of Tennessee, Knoxville, TN, USA.
Biomechanics and modeling in mechanobiology
|June 17, 2024
概括
心肺绕道 (CPB) 可以导致神经问题. 在CPB期间,更高的流率和血液稀释增加了栓塞性中风的风险,因为它促进了凝块运输到大动脉分支.
科学领域:
- 生物医学工程 生物医学工程
- 流体动力学 流体动力学
- 神经科学是一个神经科学.
背景情况:
- 神经系统并发症,包括中风和认知障碍,是使用心肺绕道 (CPB) 进行手术的重大风险.
- 在CPB期间的手术操纵是这些神经系统缺陷的主要驱动因素.
- 有关CPB期间大动脉内的血液动力学及其对栓塞事件的影响存在关键知识差距.
研究的目的:
- 为了研究血液动力学因素影响栓塞运输进入大动脉分支在心肺旁路.
- 了解CPB参数和栓塞性质对神经风险的单独和综合影响.
- 提供关于CPB期间栓塞性中风背后的机制的见解.
主要方法:
- 采用了综合实验和计算建模方法,利用计算流体动力学 (CFD) 模拟.
- 经验证的CFD模型在稳定状态条件下具有体外心肺旁路流循环.
- 进行了参数研究,对流量,血液粘度,栓塞大小和栓塞密度进行了变化.
主要成果:
- 在增加流率和栓塞输送到大动脉分支之间观察到正相关性,从而增加中风风险.
- 栓塞的运输动态取决于尺寸:较大的栓塞有利于更高的流速,而较小的栓塞在较低的流速下更为普遍.
- 在CPB期间增加血液稀释导致更多的栓塞进入大动脉分支.
- 非维的斯托克斯数有效地捕获了组合效应,显示了与栓塞运输的正相关性.
结论:
- CPB的运行条件显著影响了栓塞性中风的风险.
- 了解CPB参数和栓塞特征之间的相互作用对于减轻神经复杂症至关重要.
- 这项研究为开发在CPB手术期间减少栓塞性中风风险的策略提供了基础.
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