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流体动力学和体外血液研究,以了解导管相关血栓瘤

Hannah Palahnuk¹, Boyang Su¹, Thaddeus Harbaugh²

¹Department of Biomedical Engineering, The Pennsylvania State University, 122 Chemical and Biomedical Engineering Building, University Park, PA, USA.

Cardiovascular engineering and technology

|December 2, 2024

概括

较高的导管至静脉比率 (CVR) 与特定的流量条件相结合,显著增加了与导管相关的血栓形成 (CRT) 的风险,特别是在器件尖端. 考虑到CVR和流量,仔细放置设备对于患者的安全至关重要.

科学领域:

生物医学工程生物医学工程
医疗器械血液动力学医疗器械血液动力学
血栓形成的研究研究

背景情况:

中枢静脉导管 (CVC) 对于静脉通道至关重要,但具有与导管相关的血栓形成 (CRT) 的风险.
高的导管至静脉比率 (CVR) 是已知的CRT风险因素,表明导管直径相对于静脉大小大.

研究的目的:

调查CVR对CVC血液动力学的影响及其对CRT的后续影响.
分析CVR,流量条件 (雷诺德数) 和装置几何学对血栓形成的综合影响.

主要方法:

试管流环与粒子图像速度测量和人血被用于描述血液动力学和研究CRT.
在CVC周围进行了墙壁剪切率的数值计算.
在模拟慢性内置导管 (无光流) 的条件下,评估了CVR (0.20,0.33,0.49) 和雷诺兹数 (200,800,1300).

主要成果:

CVR ≥0.33 显著促进 CVC 尖端的富血小板血栓生长,这是由于高壁切割率梯度和远端唤醒形成.
慢性脊髓炎风险受到CVR和雷诺兹数之间的相互作用的影响;高CVR (≥0.33) 和高流量 (≥1300) 具有最高的尖端血栓形成风险.
装置几何和流量条件对于血栓和纤维素外的形成至关重要,在CVR=0.49时,无论流量如何,在整个导管上发生血栓形成.

结论:

CVR,流动力学和设备几何是CRT的关键决定因素.
建议在临床病例中密切监测CVC尖端的血栓形成,CVR≥0.33和/或Re≥1300.
考虑到雷诺兹数和CVR的综合效应,战略性设备放置对于减轻血栓形成风险至关重要.

关键词:

通过中央静脉导管导管.凝血凝血是指凝血的发生.纤维素外中的纤维素外.血液动力学血液动力学上腔静脉高层静脉静脉接入静脉接入

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