Biomedical subjects

L F Mockros

Publications and source records attributed to L F Mockros.

49 records · Page 3Linked to original sources

PubMedDate not supplied

A hypothesis regarding vascular acoustic emission accompanying arterial injury induced by balloon angioplasty.

Stress-induced structural damage is often accompanied by sound release. This behavior is known as acoustic emission (AE). We hypothesize that vascular injury such as that produced by balloon angioplasty is associated with AE. Postmortem human peripheral arterial specimens were randomly partitioned into test (n = 10) and control segments (n = 10). Test segments were inserted into a pressurization circuit and subjected to two consecutive hydrostatic pressurizations. Amplitude, frequency, and energy content of the AE signals released during pressurization were quantified. Test and matched control segments subsequently underwent identical histological processing. Pressure-induced tissue trauma was estimated via computerized histomorphometric analysis of the resulting slides (n = 100). Vascular acoustic emission (VAE) signals exhibited an amplitude range of +/- 5.0 mu bars and were observed to occur during periods of increasing intraluminal pressure. The VAE signal power within the monitored bandwidth was concentrated below 350 Hz. More than 25 times as much VAE energy was released during the first pressurization as during the second: 1,855 +/- 513.8 mJ vs. 73 +/- 44.9 mJ (mean +/- SEM, p < 0.006). Estimates of circumferential intimal wall stress at AE onset averaged 170 kPa, slightly below reported values of arterial tissue rupture strength. Histomorphometric estimates of tissue trauma was greater for the test than their matched control segments (p < 0.0001). These preliminary data suggest that detectable acoustic energy is released by vascular tissue subjected to therapeutic stress levels. Histological analysis suggest that the underlying source of sound energy may be related to tissue trauma, independent of histological preparation artifacts. From this preliminary work, we conclude that VAE may be a fundamental property accompanying vascular tissue trauma, which may have applications to improving balloon angioplasty outcomes.

Acoustics↗

PubMedDate not supplied

Development of an intravascular lung assist device.

Intravascular lung assist devices (ILADs) must provide sufficient gas transport without excessive pressure drop. In vitro studies of fiber-bundle devices determined the effect of geometric configuration on gas transfer efficiency, the amount of surface area needed to achieve sufficient gas transport, and the relationship between gas transport and blood-side pressure drop. ILADs with cross-flow fibers transfer at least 10 times more O2 than parallel flow ILADs of the same surface area, and six to eight times more CO2. Some tested devices with 0.4-0.6 m2 of surface area can transfer 100 ml/min of both O2 and CO2. Configurations with high gas transport, however, often require moderate pressure drops.

Animals↗

PubMedDate not supplied

A pumping intravascular artificial lung with active mixing.

Intravascular, as well as extracorporeal, artificial lungs need to be effective and efficient in transferring both oxygen and carbon dioxide. This paper describes the preliminary development of a device that not only is efficient in gas transfer, but also can reduce any pressure loss by providing its own pumping action. The exchange surfaces of the device consist of many short, microporous, hollow fibers arranged in layers like the threads of a screw and placed in a cross-flow configuration. Rotation of the device greatly increases gas transfer efficiency, by increasing the relative velocity between the blood and the fiber surfaces, and pushes the blood along a path similar to that of an Archime-dean screw. In vitro water tests of prototype devices indicate that the rotation can enhance the gas transfer rates by as much as a factor of six. In vitro blood studies indicate moderate blood pumping against zero pressure head, a simulation of veno-venous bypass.

Animals↗

PubMedDate not supplied

A pumping artificial lung.

The authors have developed a single device that performs the functions of a centrifugal pump and a membrane artificial lung. Unlike other systems that combine pre-existing components, our device is constructed so that the vanes of an impeller pump are made up of gas exchanging microporous fibers. The device has a variety of applications: in an easily primed emergency cardiopulmonary bypass circuit, as a low surface area component of extracorporeal life support (ECLS) circuits, and as a low volume, high perfusion rate bridge to transplant. Five prototype devices, with gas exchange surface areas ranging from 0.09 to 0.35 m2, have been tested in vitro to characterize the gas exchange and pumping capabilities of the device. These small devices pump fluid effectively. The larger device could pump 2.7 l/min with 91 mmHg pressure difference from inlet to outlet. These preliminary devices transferred to only 33 ml/min of oxygen (O2) and 35 ml/min of carbon dioxide (CO2), however. The combination of pumping ability and gas exchange is encouraging, but it is apparent that larger surface areas and less blood shunting around the gas exchanging impellers are needed for sufficient gas exchange. Somewhat higher surface areas are feasible within the pump-head casing used for these preliminary prototypes; larger casings could be used for still higher surface areas.

Artificial Organs↗

PubMedDate not supplied

Design and evaluation of a new, low pressure loss, implantable artificial lung.

The authors designed and tested an artificial lung intended for intrathoracic implantation as a bridge to lung transplantation in chronic pulmonary insufficiency or as an alternative in the treatment of advanced acute respiratory failure. The prototype devices are comprised of 380 microns outer diameter polypropylene matted fibers with a blood path length of 3.5 cm, frontal area of 128 cm2, void fraction (porosity) of 0.53, and surface area of approximately 2.2 m2. Blood flow is external and approximately perpendicular to the fiber bundle, which fits in an extruded, flexible polyethylene terephthalate housing. Inflow and outflow anastomoses are made to the pulmonary artery and the left atrium, respectively, thereby avoiding a prosthetic blood pump. Inlet and outlet gas lines exit through the chest wall. Nine in vitro experiments of oxygen (O2) transfer performance by the device, with water, initially were done. Our previously described semiempirical mathematical model of convective O2 transfer in cross-flow, hollow fiber membrane lungs was applied to the results from the water tests to predict the transfer rates at any set of blood conditions. Five in vitro blood tests were conducted using a single-pass technique to evaluate O2 and carbon dioxide (CO2) transfer rates, measure pressure losses, and compare predicted and measured O2 transfer rates. O2 transfer rates of 150-200 ml/min, and CO2 transfer rates exceeding 200 ml/min, could be achieved at blood flow rates as great as 4 l/min. Pressure drops of approximately 10-20 mmHg were observed at blood flow rates of 2-4 l/min. Preliminary results of device implantation in two pigs indicate the feasibility of achieving clinically significant O2 and CO2 transfer rates with a low blood-side pressure loss.

Animals↗

PubMedDate not supplied

A dynamic intravascular artificial lung.

Intravascular lung assist devices (ILADs) must transfer sufficient amounts of oxygen and carbon dioxide to and from limited surface areas. It has become apparent that passive devices, i.e., those without an active means for enhancing transfer, cannot achieve sufficient transfer within the space available. High speed rotation or oscillation of fiber sheets can increase transfer rates up to 800% over the rates achieved by a stationary device, judiciously configured fiber sheets cause an additional benefit when rotated: reduced resistance to blood flow across the device. The authors have developed a series of device prototypes based on these principles of transfer augmentation and minimization of flow resistance. The prototypes are small enough to fit inside the vena cava, with transfer surface areas ranging from 0.1 m2 to 0.5 m2. Transfer rates of O2 up to 53 ml/min and CO2 up to 51 ml/min and fluxes of 208 ml (min/m2) for O2 and 310 ml (min/m2) for CO2 have been achieved.

Artificial Organs↗

PubMedDate not supplied

Testing of an intrathoracic artificial lung in a pig model.

A low input impedance, intrathoracic artificial lung is being developed for use in acute respiratory failure or as a bridge to transplantation. The device uses microporous, hollow fibers in a 0.74 void fraction, 1.83 m2 surface area bundle. The bundle is placed within a thermoformed polyethylene terephthalate glucose modified housing with a gross volume of 800 cm3. The blood inlet and outlet are 18 mm inner diameter vascular grafts. Between the inlet graft and the device is a 1 inch inner diameter, thin-walled, latex tubing compliance chamber. These devices were implanted in Yorkshire pigs via median sternotomy with an end to side anastomosis to the pulmonary artery and left atrium. The distal pulmonary artery was occluded to divert the right ventricular output to the device. Pigs 1 and 2 were supported fully for 24 hrs and then killed. Pig 3 was supported partially for 20 hrs and died from bleeding complications. The first implant, in a 55 kg male pig, transferred an average of 176 ml/min +/- 42.4 of O2 and 190 ml/min +/- 39.7 of CO2 with an average blood flow rate of 2.71/min +/- 0.46. The normalized average right ventricular output power, Pn, was 0.062 W/(L/min) +/- 0.0082, and the average device resistance, R, was 3.5 mmHg/(L/min) +/- 0.62. The second implant, in a 60 kg male pig, transferred an average of 204 ml/min +/- 22.5 of O2 and 242 ml/min +/- 17.2 of CO2 with an average blood flow rate of 3.7 L/min +/- 0.45, Pn of 0.064 W/(L/min) +/- 0.0067, and R of 4.3 mmHg/(L/min) +/- 0.89. The third implant, in an 89 kg male pig, transferred an average of 156 ml/min +/- 39.6 of O2 and 187 ml/min +/- 21.4 of CO2 with an average blood flow rate of 2.5 L/min +/- 0.49, Pn of 0.052 W/(l/min) +/- 0.0067, and R of 3.4 mmHg/(L/min) +/- 0.74. These experiments suggest that such an artificial lung can temporarily support the gas transfer requirements of adult humans without over-loading the right ventricle.

Adult↗

PubMedDate not supplied

New design for a pumping artificial lung.

A new prototype of a pumping artificial lung (PAL) has been designed and tested. The device performs the functions of both the pump and oxygenator components of an extracorporeal perfusion circuit. Previous prototypes that the authors developed (Type A) had gas exchanging microporous fibers formed into propeller-like vanes that, upon rotation, pump the blood. The design of the new PAL prototypes (Type B) uses the rotation of an annular bank of fibers to drive flow. The fiber bank, including sealed gas manifolds, lies within the housing of a modified Bio-Medicus BMP-50 pump head (Bio-Medicus, Eden Prairie, MN). Rotation of the fiber bank is driven through a magnetic coupling. Inlet and outlet gas lines enter the pump head through a sealed bearing. The Type A PAL suffered from insufficient pumping rates and gas exchange, necessitating redesign. The authors have constructed two PAL-B prototypes with a priming volume of only 140 ml and gas exchange surface areas of 0.16 and 0.60 m2. During in vitro saline testing, these prototypes showed significant pump performance, pumping 7.0 L/min against zero head at 3,500 rpm. The larger prototype had exchange rates in saline of up to 71 ml O2/min and 75 ml CO2/min. Gas exchange fluxes (O2 = 119 ml/[min.m2] and CO2 = 125 ml/[min.m2]) for the PAL-B are significantly higher than that of commercially available oxygenators in saline. Future prototypes will have increased surface area and fibers smaller than the 0.038 cm outside diameter fibers used in the present prototypes. A primary concern in using microporous fibers to push the blood was the durability of the fibers at high pump speeds. High speeds exhibited no negative effects on gas exchange abilities or fiber durability.

Artificial Organs↗

PubMedDate not supplied

Hemodynamic effects of attachment modes and device design of a thoracic artificial lung.

A thoracic artificial lung (TAL) was designed to treat respiratory insufficiency, acting as a temporary assist device in acute cases or as a bridge to transplant in chronic cases. We developed a computational model of the pulmonary circulatory system with the TAL inserted. The model was employed to investigate the effects of parameter values and flow distributions on power generated by the right ventricle, pulsatility in the pulmonary system, inlet flow to the left atrium, and input impedance. The ratio of right ventricle (RV) power to cardiac output ranges between 0.05 and 0.10 W/(L/min) from implantation configurations of low impedance to those of high impedance, with a control value of 0.04 W/(L/min). Addition of an inlet compliance to the TAL reduces right heart power (RHP) and impedance. A compliant TAL housing reduces flow pulsatility in the fiber bundle, thus affecting oxygen transfer rates. An elevated bundle resistance reduces flow pulsatility in the bundle, but at the expense of increased right heart power. The hybrid implantation mode, with inflow to the TAL from the proximal pulmonary artery (PA), outflow branches to the distal PA and the left atrium (LA), a band around the PA between the two anastomoses, and a band around the outlet graft to the LA, is the best compromise between hemodynamic performance and preservation of some portion of the nonpulmonary functions of the natural lungs.

Artificial Organs↗

PubMedDate not supplied

Development of an implantable artificial lung: challenges and progress.

Unlike dialysis, which functions as a bridge to renal transplantation, or a ventricular assist device, which serves as a bridge to cardiac transplantation, no suitable bridge to lung transplantation exists. Our goal is to design and build an ambulatory artificial lung that can be perfused entirely by the right ventricle and completely support the metabolic O2 and CO2 requirements of an adult. Such a device could realize a substantial clinical impact as a bridge to lung transplantation, as a support device immediately post-lung transplant, and as a rescue and/or supplement to mechanical ventilation during the treatment of severe respiratory failure. Research on the artificial lung has focused on the design, mode of attachment to the pulmonary circulation, and intracorporeal versus paracorporeal placement of the device.

Artificial Organs↗

PubMedDate not supplied

Rapid platelet separation and collection for postoperative autologous transfusion.

The authors describe a technique for rapid, on-line, precardiopulmonary bypass separation and collection of 10-20% of a patient's platelets for storage and postoperative reinfusion. In a three stage process, blood is diverted through a hollow fiber hemofilter and platelets are concentrated near the fiber walls; the core is flushed of whole blood and the concentrated platelets are collected. Process mechanics were investigated in vitro with bovine blood; efficacy was studied with in vivo ovine experiments; and platelet function and viability were examined with in vitro human blood tests. Using commercially available hemofilters with 13,000 polyacrylonitrile fibers, the authors collected 1 x 10(11) to 2 x 10(11) platelets in 250 ml in 3.5 min. With fresh human blood, collected platelets exhibited normal morphology and aggregation response to adenosine diphosphate, collagen, and thrombin for 4 hours after collection.

Animals↗

PubMedDate not supplied

Mixing of two solutions combined by gravity drainage.

A variety of medical therapies require the mixing of solutions from two separate bags before use. One scenario for the mixing is to drain the solution from one bag into the other by gravity through a short connecting tube. The degree of mixing in the lower bag depends on the relative densities of the two solutions, the geometry of the two bags and the connecting tube, and the placement of the connecting tube. Solutions with densities differing by as much as 12% were mixed by draining the solution from an upper bag into a lower bag for a particular geometric configuration. The two solutions had different electrical conductivities, and the conductivity of the combined solution as it exited from the lower bag was used as a measure of the effectiveness of mixing. When the more dense solution was drained from the upper bag into the less dense solution in a lower bag, mixing was very effective. The incoming jet of high density solution entrained the low density solution. Flow visualization indicated that the incoming jet penetrated to the bottom of the lower bag, and resulting large vortical structures enhanced mixing. When the less dense solution was drained from the upper bag into the more dense solution in the lower bag mixing was less effective. The buoyancy force reduced the momentum of the incoming jet such that it did not penetrate to the bottom of the lower bag, resulting in stratification of the solutions.

Drug Compounding↗

PubMedDate not supplied

Use of a mathematical model to predict oxygen transfer rates in hollow fiber membrane oxygenators.

A semi-empirical theoretical model of oxygen transfer is used to predict the rates of oxygen transfer to blood in hollow fiber membrane oxygenators over a wide range of inlet conditions. The predicted oxygen transfer rates are based on performance of the devices with water, which is more cost effective and easier to handle than blood for in vitro evaluations. Water experiments were conducted at three different flow rates to evaluate oxygen transfer performance in three commercially available membrane oxygenators. Data obtained from these experiments were used in a computer model to predict the rate of oxygen transfer to bovine blood at specified inlet conditions. Blood experiments were conducted at three different flow rates at a wide variety of inlet conditions, including different pH levels, hemoglobin concentrations, and oxyhemoglobin saturations for the three types of oxygenators. The measured and predicted oxygen transfer rates are closely correlated, which suggests that we have an accurate, reliable method for predicting oxygen transfer in hollow fiber membrane lungs.

Animals↗