Abstract
Since the use of continuous flow blood pumps as ventricular assist devices is standard, the problems with haemolysis have increased. It is mainly induced by shear stress affecting the erythrocyte membrane. There are many investigations about haemolysis in laminar and turbulent blood flow. The results defined as threshold levels for the damage of erythrocytes depend on the exposure time of the shear stress, but they are very different, depending on the used experimental methods or the calculation strategy. Here, the results are resumed and shown in curves. Different models for the calculation of the strengths of erythrocytes are discussed. There are few results reported about tests of haemolysis in blood pumps, but some theoretical approaches for the design of continuous flow blood pumps according to low haemolysis have been investigated within the last years.
Highlights
The term ‘haemolysis’ refers to the dissolution or degradation of erythrocytes
The aim of this review is to provide an overview of the current status of research on the strength of erythrocytes and the theoretical assessment of haemolysis in blood pumps
Computational fluid dynamics (CFD) analyses in HeartMate II (Thoratec Corp., Pleasanton, CA, USA) and HeartWare HeartWare ventricular assist device (HVAD) (HeartWare Inc., Framingham, MA, USA) pumps showed no significant difference in the occurring shear stresses
Summary
The term ‘haemolysis’ refers to the dissolution or degradation of erythrocytes. In the normal life cycle of the red blood cell (RBC), this degradation occurs after about 120 days. The aged and inelastic cells are destroyed by mechanical stress and the haemoglobin contained in them is released into the blood plasma and degraded in the liver, where the iron atoms are recycled. The concentration of free haemoglobin in blood caused by natural haemolysis is about 0.5-2.0 mg/100 L. Premature erythrocyte loss can be caused by unnatural haemolysis as a result of increased mechanical stress on the RBC, resulting in increased permeability of the cell membrane for haemoglobin or rupturing of the cell membrane. Haemolysis is caused by substances that attack the components of the cell membrane, such as soaps, animal toxins and lysing antibodies. The aim of this review is to provide an overview of the current status of research on the strength of erythrocytes and the theoretical assessment of haemolysis in blood pumps. The existing studies about haemolysis in blood pumps are summarized
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