Jiafeng Zhang

Blood pumps have been increasingly used in mechanically assisted circulation for ventricular assistance and extracorporeal membrane oxygenation support or during cardiopulmonary bypass for cardiac surgery. However, there have always been common complications such as thrombosis, hemolysis, bleeding, and infection associated with current blood pumps in patients. The development of more biocompatible blood pumps still prevails during the past decades. As one of those newly developed pumps, the Breethe pump is a novel extracorporeal centrifugal blood pump with a hybrid magnetic and mechanical bearing with attempt to reduce device-induced blood trauma. To characterize the hydrodynamic and hemolytic performances of this novel pump and demonstrate its superior biocompatibility, we use a combined computational and experimental approach to compare the Breethe pump with the CentriMag and Rotaflow pumps in terms of flow features and hemolysis under an operating condition relevant to ECMO support (flow: 5 L/min, pressure head: ~350 mmHg). The computational results showed that the Breethe pump has a smaller area-averaged wall shear stress (WSS), a smaller volume with a scalar shear stress (SSS) level greater than 100 Pa and a lower device-generated hemolysis index compared to the CentriMag and Rotaflow pumps. The comparison of the calculated residence times among the three pumps indicated that the Breethe pump might have better washout. The experimental data from the in vitro hemolysis testing demonstrated that the Breethe pump has the lowest normalized hemolysis index (NIH) than the CentriMag and Rotaflow pumps. It can be concluded based on both the computational and experimental data that the Breethe pump is a viable pump for clinical use and it has better biocompatibility compared to the clinically accepted pumps.

The regions with high non-physiological shear stresses (NPSS) are inevitable in blood-contacting medical devices (BCMDs) used for mechanically assisted circulatory support. NPSS can cause platelet activation and receptor shedding potentially resulting in the alteration of hemostatic function. In this study, we developed a dissipative particle dynamics model to characterize clot formation (platelet–collagen and inter-platelet adhesion) of NPSS-traumatized blood at a vascular injury site. A rectangular tube of 50 × 50 × 200 µm with an 8 × 8 µm collagen-coated area was modeled as a small blood vessel and perfusion with blood. Clot formation dynamics during perfusion was simulated. NPSS-traumatized blood was modeled to have more activated platelet and fewer adhesion receptors with weakened inter-platelet binding. Computational results showed that clots grew at a faster rate while the structure of the clots was less stable and collapsed more frequently for NPSS-traumatized blood compared with normal blood. The finding that NPSS-traumatized platelets could result in quicker but more easily breakable blood clots at injury sites may explain why increased risks of thrombotic and bleeding complications occurred concurrently in patients implanted with BCMDs.

This work introduces a new Lagrangian strain‐based model to predict the shear‐induced hemolysis in biomedical devices. Current computational models for device‐induced hemolysis usually utilize empirical fitting of the released free hemoglobin (Hb) in plasma from damaged red blood cells (RBCs). These empirical correlations contain parameters that depend on specific device and operating conditions, thus cannot be used to predict hemolysis in a general device. The proposed algorithm does not have any empirical parameters, thus can presumably be used for hemolysis prediction in various blood‐wetting medical devices. In contrast to empirical correlations in which the Hb release is related to the shear stress and exposure time without considering the physical processes, the proposed model links flow‐induced deformation of the RBC membrane to membrane permeabilization and Hb release. In this approach, once the steady‐state numerical solution of blood flow in the device is obtained under a prescribed operating condition, sample path lines are traced from the inlet of the device to the outlet to calculate the history of the shear stress tensor. In solving the fluid flow, it is assumed that RBCs do not have any influence on the flow pattern. Along each path line, shear stress tensor will be input into a coarse‐grained (CG) RBC model to calculate the RBC deformation. Then the correlations obtained from molecular dynamics (MD) simulations are applied to relate the local areal RBC deformation to the perforated area on the RBC membrane. Finally, Hb released out of transient pores is calculated over each path line via a diffusion equation considering the effects of the steric hindrance and increased hydrodynamic drag due to the size of the Hb molecule. The total index of hemolysis (IH) is calculated by integration of released Hb over all the path lines in the computational domain. Hemolysis generated in the Food and Drug Administration (FDA) nozzle and two blood pumps, that is, a CentriMag blood pump (a centrifugal pump) and HeartMate II (an axial pump), for different flow regimes including the laminar and turbulent flows are calculated via the proposed algorithm. In all the simulations, the numerical predicted IH is close to the range of experimental data. The results promisingly indicate that this multiscale approach can be used as a tool for predicting hemolysis and optimizing the hematologic design of other types of blood‐wetting devices.

The goal of this study is to develop a computational fluid dynamics (CFD) modeling approach to better estimate the blood flow dynamics in the bundles of the hollow fiber membrane based medical devices (i.e., blood oxygenators, artificial lungs, and hemodialyzers). Three representative types of arrays, square, diagonal, and random with the porosity value of 0.55, were studied. In addition, a 3D array with the same porosity was studied. The flow fields between the individual fibers in these arrays at selected Reynolds numbers (Re) were simulated with CFD modeling. Hemolysis is not significant in the fiber bundles but the platelet activation may be essential. For each type of array, the average wall shear stress is linearly proportional to the Re. For the same Re but different arrays, the average wall shear stress also exhibits a linear dependency on the pressure difference across arrays, while Darcy's law prescribes a power-law relationship, therefore, underestimating the shear stress level. For the same Re, the average wall shear stress of the diagonal array is approximately 3.1, 1.8, and 2.0 times larger than that of the square, random, and 3D arrays, respectively. A coefficient C is suggested to correlate the CFD predicted data with the analytical solution, and C is 1.16, 1.51, and 2.05 for the square, random, and diagonal arrays in this paper, respectively. It is worth noting that C is strongly dependent on the array geometrical properties, whereas it is weakly dependent on the flow field. Additionally, the 3D fiber bundle simulation results show that the three-dimensional effect is not negligible. Specifically, velocity and shear stress distribution can vary significantly along the fiber axial direction.