Adjustable Shunt Pediatric ECMO Circuit Design
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Solution Overview
Problem
Current pediatric ECMO circuits face challenges with low blood flow rates, leading to thrombus formation and the need for frequent circuit replacement, which can cause inflammatory reactions and morbidity/mortality, especially in neonatal applications where anticoagulant levels must be minimized to avoid 'brain bleeds'.
Innovation Solution
The design incorporates a medium diameter venous and arterial line system with adjustable shunts and a stopcock to control blood flow, reducing connectors in the patient blood path and increasing overall blood flow through the oxygenator, while maintaining adequate flow to the patient, using specific tubing sizes and connectors to enhance blood flow and minimize thrombus formation.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Object-affected harmful factors
If low blood flow rates are used in pediatric ECMO circuits, then anticoagulant levels can be minimized to avoid brain bleeds in neonates, but thrombus formation increases and requires frequent circuit replacement
Solution Approach 1:
The circuit is divided into multiple shunt lines with adjustable flow control, allowing segmentation of blood flow paths. This enables independent control of flow distribution between the patient and the shunt, permitting optimization of anticoagulation levels while maintaining adequate flow rates to prevent thrombus formation in the oxygenator.
Solution Approach 2:
The shunt lines incorporate adjustable flow control mechanisms (such as flow meters or adjustable clamps) that allow dynamic modification of blood flow rates. This dynamic adjustability enables the system to adapt flow rates to match patient needs while maintaining sufficient flow through the oxygenator to prevent thrombus formation, even at lower overall blood flow rates.
2Reliability
If higher blood flow rates are used through the oxygenator, then thrombus formation is prevented, but the required blood flow to the patient may exceed prescribed levels
Solution Approach 1:
The blood flow is segmented into multiple paths: the primary path through the patient and secondary paths through the shunt lines. This segmentation allows the system to deliver the required blood flow to the patient while simultaneously maintaining adequate flow rates through the oxygenator via the shunt, preventing thrombus formation without exceeding prescribed patient flow levels.
Solution Approach 2:
Flow control mechanisms in the shunt lines provide feedback on blood flow rates, allowing real-time adjustment. This feedback enables the system to maintain adequate flow through the oxygenator to prevent thrombus formation while ensuring the blood flow to the patient remains within prescribed levels, through continuous monitoring and adjustment.
3Adaptability or versatility
If multiple connectors are placed in the patient blood path for sampling and medication, then access for monitoring and treatment is improved, but each connector becomes a location for thrombus deposition
Solution Approach 1:
The shunt lines are extracted as separate access points from the main patient blood path. This extraction allows sampling and medication administration to be performed through the shunt lines rather than at multiple connectors in the primary circuit, reducing the number of potential thrombus deposition sites in the patient blood path while maintaining necessary access for monitoring and treatment.
Data Source
AI summary
Embodiments provide an extra corporeal membrane oxygenation circuit, wherein a pump communicates blood from a patient to an oxygenator and thence back to the patient, comprising: a medium diameter venous line configured to accept blood from the patient and communicate the blood to the pump; a medium diameter arterial line configured to accept blood from the oxygenator and communicate the blood to the patient; one or more shunts connected in a series; wherein a first of such shunts is connected to accept blood from the venous line in parallel with the pump and wherein a last of such shunts is connected to communicate blood to the arterial line.