Improving Trendelenburg position effectiveness by varying cardiopulmonary bypass flow

No Thumbnail Available
File version
Author(s)
Ho, Raymond
McDonald, Charles
Pauls, Jo P
Li, Zhiyong
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
2022
Size
File type(s)
Location
License
Abstract

Introduction: Trendelenburg position (TP) is used to transport gaseous emboli away from the cerebral region during cardiac surgery. However, TP effectiveness has not been fully considered when combined with varying the cardiopulmonary bypass (CPB) flow. This study simulated the supine and TP at different pump flows and assessed the trapped emboli and embolic load entering the aortic arch branch arteries (AABA). Methods: A computational fluid dynamics (CFD) approach used a centrally cannulated adult patient-specific aorta model replicating a CPB circuit. Air emboli of 0.1 mm, 0.5 mm, and 1.0 mm (n = 700 each) were injected into the aorta placed in the supine position (0°) and the TP (−20°) at 2 L/min and 5 L/min. The number of emboli entering the AABA were compared. An aortic phantom flow experiment was performed to validate air bubble behaviour. Results: TP at 5 L/min had the lowest 0.1 mm mean (±SD) embolic load compared to the supine 2 L/min (55.3 ± 30.8 vs 64.3 ± 35.4). For both the supine and TP, the lower flow of 2 L/min had the highest number of simulated trapped emboli in higher elevated regions than at 5 L/min (541 ± 185 and 548 ± 191 vs 520 ± 159 and 512 ± 174), respectively. The flow experiment demonstrated that 2 L/min promoted bubble coalescence and high amounts of trapped emboli and 5 L/min transported air emboli away from the AABA. Conclusions: TP effectiveness was improved by using CPB flow to manage air emboli. These results provide insights for predicting emboli behaviour and improving emboli de-airing procedures.

Journal Title

Perfusion

Conference Title
Book Title
Edition
Volume
Issue
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note

This publication has been entered in Griffith Research Online as an advanced online version.

Access the data
Related item(s)
Subject

Surgery

Cardiology (incl. cardiovascular diseases)

Science & Technology

Life Sciences & Biomedicine

Cardiac & Cardiovascular Systems

Peripheral Vascular Disease

Cardiovascular System & Cardiology

Persistent link to this record
Citation

Ho, R; McDonald, C; Pauls, JP; Li, Z, Improving Trendelenburg position effectiveness by varying cardiopulmonary bypass flow, Perfusion, 2022

Collections