Effect Of Blood Viscosity Research Articles

Effect of blood viscosity on the hemodynamics of arteriovenous fistulae based on numerical investigation

Arteriovenous fistula (AVF) is the most commonly used vascular access for hemodialysis in patients with end-stage renal disease. Vascular diseases such as atherosclerosis and thrombosis, triggered by altered hemodynamic conditions, are the main causes of access failure. Changes in blood viscosity accelerate access dysfunction by affecting local velocities and wall shear stress (WSS) distribution in the circulation. Numerical simulation was employed to analyze and compare the hemodynamic behavior of AVF under different blood viscosities (0.001–0.012 Pa∙s). An idealized three-dimensional model with end-to-side anastomosis was established. Transient simulations were conducted using pulsatile inlet velocity and outflow as boundary conditions. The simulation results reveal the blood flow state of AVF under different viscosity physiological conditions and derive the rule of change. When blood viscosity increases, the local velocity in the disturbed region slows down and the stagnation time becomes longer, resulting in increased deposition of substances. As blood viscosity increases, the level of shear stress on the entire wall of the fistula increases accordingly. WSS values at high viscosities above 0.007 Pa∙s showed significantly larger low-shear regions near the anastomosis and increased chances of inducing atheromatous plaques. This research has revealed the correlation between blood dynamic viscosity and the hemodynamic behavior of AVF. Elevated whole blood viscosity increases the incidence of access obstruction and vascular disease leading to fistula failure. The study provides a basis for optimizing the distribution of hemodynamic parameters in the fistula for hemodialysis patients.

Effects of blood viscosity on early neurological deterioration in patients with acute ischemic stroke of small vessel occlusion

Effects of blood viscosity on early neurological deterioration in patients with acute ischemic stroke of small vessel occlusion

Multiphysics analysis for fluid–structure interaction of blood biological flow inside three-dimensional artery

Abstract With the development of simulation programs, it is necessary to simulate the problems that occur in the human body that are related to mechanical engineering. Whereas blood is a liquid with mechanical properties, the artery is a substance that also contains mechanical properties. Smoking increases blood viscosity, and this viscosity affects the velocity and blood pressure as well as the artery itself. In this research article, the effect of blood viscosity on the aorta will be studied because it is one of the main arteries of the heart and obtains blood flow in the artery. The blood’s kinetic equations were solved using the COMSOL program’s laminar processor, and fluid–structure interaction was utilized to connect the mechanics of motion with the stresses that affect the artery. In addition, the effect of viscosity on the deformation of the artery and its movement was studied, and the result showed that most of the blood does not reach the branches of the artery, where the speed of blood flow was 0.18 m/s at the value of the viscosity of 0.1 Pa s. The increase in viscoelasticity leads to an increase in pressure at the beginning of the carotid artery, which hinders the flow of blood. The velocity of blood flow decreases with the increase in viscosity, and this reduces pressure on the artery walls, as the stress on 0.1 Pa s was equal to 16,705 Pa s (m.124). An artery’s deformation is directly related to the stresses on it, and when the deformation goes down, the artery’s size goes down.

CFD investigations of the blood hemodynamic inside internal cerebral aneurysm (ICA) in the existence of coiling embolism

The coiling technique is the most significant and conventional option for treating an intracranial aneurysm. Besides, the effects of blood hemodynamics are also known as the important factor for the growth and rupture of the aneurysm. In this work, transient simulations of the blood stream inside the cerebral aneurysm are performed to disclose the impacts of blood velocity on the risk of aneurysm rupture. The effects of blood viscosity and coiling treatment on the distribution of WSS and OSI factors are comprehensively discussed. Our main attention is to investigate the blood hemodynamics on the size of the high-risk regions on the aneurysm wall. One-way FSI is used for modeling blood and vessel interaction in our model. Our results show that increasing the coiling permeability considerably restricted the WSS and OSI value on the sac surface. According to our achievements, the influence of coiling is considerably higher in low blood viscosity (HCT = 0.35) and the average OSI reduction is about 55 % when the coiling porosity is reduced from 0.89 to 0.79.

Influence of the coiling porosity on the risk reduction of the cerebral aneurysm rupture: computational study

The formation and progress of cerebral aneurysm is highly associated with hemodynamic factors and blood flow feature. In this study, comprehensive efforts are done to investigate the blood hemodynamic effects on the creation and growth of the Internal Carotid Artery. The computational fluid dynamic method is used for the visualization of the bloodstream inside the aneurysm. Transitional, non-Newtonian and incompressible conditions are considered for solving the Navier–Stokes equation to achieve the high-risk region on the aneurysm wall. OSI and WSS of the aneurysm wall are compared within different blood flow stages. The effects of blood viscosity and coiling treatment on these factors are presented in this work. Our study shows that in male patients (HCT = 0.45), changing the porosity of coiling from 0.89 with 0.79 would decreases maximum OSI up to 75% (in maximum acceleration). However, this effect is limited to about 45% for female patients (HCT = 0.35).

High-Throughput Imaging of Blood Flow Reveals Developmental Changes in Distribution Patterns of Hemodynamic Quantities in Developing Zebrafish.

Mechanical forces from blood flow and pressure (hemodynamic forces) contribute to the formation and shaping of the blood vascular network during embryonic development. Previous studies have demonstrated that hemodynamic forces regulate signaling and gene expression in endothelial cells that line the inner surface of vascular tubes, thereby modifying their cellular state and behavior. Given its important role in vascular development, we still know very little about the quantitative aspects of hemodynamics that endothelial cells experience due to the difficulty in measuring forces in vivo. In this study, we sought to determine the magnitude of wall shear stress (WSS) exerted on ECs by blood flow in different vessel types and how it evolves during development. Utilizing the zebrafish as a vertebrate model system, we have established a semi-automated high-throughput fluorescent imaging system to capture the flow of red blood cells in an entire zebrafish between 2- and 6-day post-fertilization (dpf). This system is capable of imaging up to 50 zebrafish at a time. A semi-automated analysis method was developed to calculate WSS in zebrafish trunk vessels. This was achieved by measuring red blood cell flow using particle tracking velocimetry analysis, generating a custom-made script to measure lumen diameter, and measuring local tube hematocrit levels to calculate the effective blood viscosity at each developmental stage. With this methodology, we were able to determine WSS magnitude in different vessels at different stages of embryonic and larvae growth and identified developmental changes in WSS, with absolute levels of peak WSS in all vessel types falling to levels below 0.3 Pa at 6 dpf. Additionally, we discovered that zebrafish display an anterior-to-posterior trend in WSS at each developmental stage.

The effect of blood viscosity on shear-induced hemolysis using a magnetically levitated shearing device.

Blood contacting medical devices, including rotary blood pumps, can cause shear-induced blood damage that may lead to adverse effects in patients. Due in part to an inadequate understanding of how cell-scale fluid mechanics impact red blood cell membrane deformation and damage, there is currently not a uniformly accepted engineering model for predicting blood damage caused by complex flow fields within ventricular assist devices (VADs). We empirically investigated hemolysis in a magnetically levitated axial Couette flow device typical of a rotary VAD. The device is able to accurately control the shear rate and exposure time experienced by blood and to minimize the effects of other uncharacterized stresses. Using this device, we explored the effects of both hematocrit and plasma viscosity on shear-induced hemolysis to characterize blood damage based on the viscosity-independent shear rate, rather than on shear stress. Over a shear rate range of 20 000 - 80 0001/s, the Index of Hemolysis (IH) was found to be dependent upon and well-predicted by the shear rate alone. IH was independent of hematocrit, bulk viscosity, or the suspension media viscosity and less correlated to shear stress (MSE=0.46-0.75) than to shear rate (MSE=0.06-0.09). This study recommends that future investigations of shear-induced blood damage report findings with respect to the viscosity-neutral term of shear rate, in addition to the bulk whole blood viscosity measured at an appropriate shear rate relevant to the flow conditions of the device.

Redefining Hyperviscosity in Acute Leukemia: Implications for Red Cell Transfusions

Hyperleukocytosis, most commonly defined as a white blood cell (WBC) count greater than 100,000/μL, is an emergency in acute leukemia, possibly resulting in life-threatening microvascular obstruction, or leukostasis, leading to neurologic (CNS hemorrhage, thrombosis) or pulmonary (respiratory distress, hypoxia) complications. The underlying mechanisms remain poorly understood and are canonically attributed to blood hyperviscosity secondary to high WBC count and abnormal biophysical properties of leukemia cells themselves (leukemia immunophenotype, increased cell size, adhesion, and stiffness). Leukapheresis is a commonly-used therapy for rapid cytoreduction in symptomatic patients, but the procedure carries risk and existing guidelines are supported by scant evidence. Interestingly, despite hematocrit(Hct)/hemoglobin(Hgb) levels being major drivers of blood viscosity due to the high prevalence of circulating red cells (RBCs), how Hct/Hgb mediates hyperviscosity in acute leukemia is unknown. This is clinically important as Hct/Hgb often decrease as leukemic cell counts rise, and acute leukemia patients with anemia are often transfused. While sickle cell disease guidelines advise using a target post transfusion Hct of 30% to minimize iatrogenic hyperviscosity and its morbid complications, no guidelines have been established for acute leukemia. As such, can RBC transfusion actually increase leukostasis risk in acute leukemia?To explore this question requires new biophysical tools as the complexity of blood viscosity increases substantially at the microvascular level as the physical properties of the cells themselves become the major determinants of resistance to blood flow. To that end, we developed “microvasculature-on-a-chip” devices that recapitulate microvascular biophysical and hemodynamic conditions to investigate how the differing presentations of acute leukemia and transfusion support affect the effective blood viscosity at the microvascular level to cause “in vitro leukostasis.”A multiple-vessel “multiplex” microfluidic device that operates at the appropriate size scale and mimics the microvascular geometry was designed to enable assessing accurate biophysical measurements of blood hyperviscosity. The devices were microfabricated using standard polydimethylsiloxane-based photolithography (Figure 1). Acute B-cell lymphoblastic (B-ALL, 697), acute T-cell lymphoblastic (T-ALL, Jurkat) and acute myelocytic (AML, HL60) leukemia cell lines were maintained via standard cell culture conditions. Patient samples were obtained through our institution's IRB. RBCs from healthy donors were isolated and mixed with leukemia cells to achieve target Hct/Hgb and WBC levels. Various physiologic leukemia “mixtures” were then perfused under physiologic microcirculatory flow conditions through the microvascular device and microchannels occlusion was tracked via videomicroscopy (Figure 2).Using a standard least squares multivariable linear regression with first and second order effects, microchannel size, Hct/Hgb, WBC count and leukemia cell type all showed statically significant effect on in vitro leukostasis, or microchannel occlusion over time, (all p values < 0.03) (Figure 3). Overall, severe anemia appears to be protective against in vitro leukostasis and there appears to be Hct/Hgb thresholds above which in vitro leukostasis becomes more prevalent, though this is different for B-ALL versus T-ALL. This is in contrast to AML, where severe anemia does not appear to offer protection against in vitro leukostasis as occlusion was appreciated at all Hct/Hgb levels.These data suggest when determining risk for leukostasis, WBC count and leukemia immunophenotype should not be the sole determinants. Here we show Hct/Hgb levels affect microvascular blood viscosity and risk for microvascular occlusion. These results may impact decisions regarding RBC transfusions and possibly initiation of leukapheresis in asymptomatic patients. Having a model to assess risk associated with RBC transfusions and informing clinicians when a patient might become at risk for leukostasis can have a significant impact on their clinical outcome, morbidity and mortality. Ongoing studies incorporating patient lymphoid and myeloid leukemia cells are needed to support this cell line data. [Display omitted] DisclosuresKemp: Parthenon Therapeutics: Membership on an entity's Board of Directors or advisory committees. Lam: Sanguina, Inc.: Current holder of individual stocks in a privately-held company.

Incorporating Hemoglobin Levels to Map Leukostasis Risk in Acute Leukemia Using Microvasculature-on-Chip Technologies

Hyperleukocytosis, most commonly defined as a white blood cell (WBC) count &amp;gt; 100,000/μL, is an oncologic emergency in acute leukemia that can lead to leukostasis, which occurs when leukemia cells obstruct the microvasculature resulting in significant morbidity and mortality from neurologic (CNS hemorrhage, thrombosis) or pulmonary (respiratory distress, hypoxia) symptoms. The underlying mechanisms are poorly understood but are thought to be related to increased blood viscosity, secondary to high WBC count, leukemia cell aggregation, and the abnormal mechanical properties, size, and cell-cell interactions of leukemia cells. Leukapheresis is a commonly used therapy for rapid cytoreduction in symptomatic patients, but the procedure is not without risks. No existing methods reliably predict leukostasis or guide treatment including the commonly used WBC count, which only loosely correlates with leukostasis and does not accurately describe the blood viscosity at the microvascular level. Importantly, while hematocrit/hemoglobin levels (Hgb) are known to be major contributors to blood viscosity, they have not been systematically assessed in leukostasis risk, and Hgb often decreases as leukemic cell counts rise, complicating the issue. Incorporating Hgb levels may better predict leukostasis and assist physicians balancing the risk of hyperleukocytosis compared to the interventions themselves. To that end, we investigated how the differing presentations of acute leukemia lead to microvessel occlusion, thereby affecting effective blood viscosity at the microvascular level using "microvasculature-on-a-chip" devices that mimic the microvascular geometry (Figure 1) developed by our laboratory. This physiologically relevant microvascular model allows for in vitro investigation as in vivo studies are nearly impossible due to difficulty in visualizing and manipulating the animal microvasculature and cell counts. The devices were microfabricated using polydimethylsiloxane (PDMS). Acute T-cell lymphoblastic (Jurkat) and acute monocytic (THP-1) cell lines were maintained via standard cell culture conditions. Red cells from healthy donors were isolated and mixed with leukemia cells to achieve target Hgb and WBC levels. Various physiologic leukemia "mixtures" were then perfused under physiologic microcirculatory flow conditions through the microvascular device and microchannels occlusion was tracked via videomicroscopy (Figure 2). With T-cell leukemia, Hgb levels affected the risk of "in vitro leukostasis." Specifically, with severe anemia and WBC count less than the hyperleukocytosis range, time to microchannel occlusion was longer, and was more dependent on Hgb rather than WBC count. However, in cases with severe anemia and WBC counts &amp;gt; 100k/μL, WBC count exhibited a stronger effect on occlusion with little dependence on Hgb (Figure 3). At Hgb &amp;gt; 8g/dL, microchannel occlusion was dependent on WBC count regardless of hyperleukocytosis or not. In contrast, our data to date shows that with myeloid leukemia, in vitro leukostasis is not associated with Hgb levels, and is consistent with how myeloid leukemias in vivo cause leukostasis symptoms at lower WBC counts than lymphoid leukemias, not only due to size but also adhesive interactions. These data suggest when determining risk for leukostasis, WBC count should not be the sole determinant. Here we show Hgb levels affect microvascular blood viscosity and propensity for microvascular occlusion, but it appears to have a greater impact with T-cell leukemias versus myeloid leukemias (Figure 4). These studies indicate Hgb is an important clinical parameter for leukostasis risk in acute leukemia and will help inform guidelines for leukapheresis and even phlebotomy, a much simpler and safer procedure, to mitigate hyperviscosity in acute leukemia. These results can also impact decisions regarding the need for red blood cell transfusions, which iatrogenically increase blood viscosity. Studies incorporating patient myeloid and lymphoid leukemia cells and microvasculature-on-chip devices integrating live endothelium to assess leukemia cell adhesion are ongoing. Figure Disclosures Lam: Sanguina, Inc: Current equity holder in private company.

EVALUATION OF LEFT VENTRICULAR FILLING PRESSURE USING NUMERICAL MODELING

The main objective of this work is to study the effect of blood pressure and viscosity on flow in a pathological and healthy anatomy. The method chosen for this project is the numerical simulation of fluid dynamics. First, a radiological database from Tlemcen hospital was studied in order to select a patient whose aortic anatomy is representative of the pathology studied in this research project. The left ventricle was segmented using SolidWork software. The exported data made it possible to model this geometry on Comsol software. The geometry has been idealized to make it comparable to a given healthy left ventricle geometry and present the main parameters which influence the ventricular hemodynamics. A first series of numerical simulations made it possible to highlight the hemodynamic disturbances associated with the pathology of interest and described extensively in the literature. A second series of numerical simulations made it possible to model the effect of blood viscosity on flow. All the results obtained, the modeling of the left ventricle, must be valid experimentally. This study therefore does not completely justify the treatment of ventricular dilation with a flow modulator but constitutes an important first step towards a proof of concept.

Online Prediction of Normal Blood Viscosity During Cardiopulmonary Bypass Using Hematocrit- and Temperature-Dependent Model

This paper proposes a mathematical model for online prediction of the hematocrit- and temperature-based normal blood viscosity during cardiopulmonary bypass (CPB). Clinical trials were performed using a previously developed continuous blood viscosity monitoring system, and continuous pressure- and flow-based instantaneous viscosity (η e ) data were collected from 40 patients subjected to mild to moderate hypothermic CPB. The hematocrit and blood temperature data corresponding to η e were also acquired. It was found that the blood viscosity-temperature curves for the different hematocrit levels can be well fitted using linear models, with the parameters of the linear model (slopes and intersects) also exhibiting linear relationships with the hematocrit. Based on these relationships, we were able to predict the hematocrit- and temperature-based normal viscosity (η 0 ). To test the prediction accuracy, η 0 was compared with η e using the leave-one-out cross-validation procedure. Furthermore, η 0 and the offline-measured viscosity (η), determined using a conventional viscometer, were compared for 20 patients subjected to mildly hypothermic CPB. η 0 and η e -two online blood viscosity monitoring methods based on different principles-showed good agreement (R 2 = 0.74 and p <; 0.0001). Moreover, η 0 and η also showed good agreement (R 2 = 0.69 and p <; 0.0001). The proposed model is suitable for online prediction of the hematocrit- and temperature-based normal blood viscosity during CPB. The proposed model can function as the core of a future application for investigating the effects of blood viscosity during clinical perfusion management and facilitate detailed online blood viscosity studies.

Effect of blood viscosity on the performance of virtually wall-less venous cannulas.

This study was designed to quantify the influence of blood as test medium compared to water in cannula bench performance assessment. An in vitro circuit was set-up with silicone tubing between two reservoirs. The test medium was pumped from the lower reservoir by centrifugal pump to the upper reservoir. The test-cannula was inserted in a silicone tube connected between the lower reservoir and the centrifugal pump. Flow rate and pump inlet-pressure were measured for wall-less versus thin-wall cannula using a centrifugal pump in a dynamic bench-test for an afterload of 40-60 mmHg using two media: blood 10 g/dL and 5.6 g/dL and water 0 g/dL. The wall-less cannula showed significantly higher flows rates as compared to the thin-wall cannula (control), with both hemoglobin concentrations and water. Indeed, for a target volume of 200-250 mL of blood (Hg 10 g/dL) in the upper reservoir, the cannula outlet pressure (P) was -14 ± 14 mmHg versus -18 ± 11 mmHg for the wall-less and control respectively; the cannula outlet flow rate (Q) was 3.91 ± 0.41 versus 3.67 ± 0.45 L/min, respectively. At the same target volume but with a Hg of 5.7 g/dL, P was -16 ± 12 mmHg versus -19 ± 12 mmHg and Q was 4 ± 0.1 versus 4 ± 0.4 L/min for the wall-less cannula and control respectively. Likewise, P and Q values with water were -1 mmHg versus -0.67 ± 0.58 mmHg and 4.17 ± 0.45 L/min versus 4.08 ± 0.47 L/min for the wall-less and control respectively. Walls-less cannula showed 5.6% less pump inlet-pressure differences calculated between blood and water, as compared to that of thin-wall cannula (-21 times). Flow differences were 6% and 10% for the walls-less and thin-wall cannula respectively. We conclude that testing the cannula performance with water is a good scenario and can overestimate the flow by a 10%. However, superiority for wall-less is preserved with both water and blood.

A parallel fluid–solid coupling model using LAMMPS and Palabos based on the immersed boundary method

The study of viscous fluid flow coupled with rigid or deformable solids has many applications in biological and engineering problems, e.g., blood cell transport, drug delivery, and particulate flow. We developed a partitioned approach to solve this coupled Multiphysics problem. The fluid motion was solved by Palabos (Parallel Lattice Boltzmann Solver), while the solid displacement and deformation was simulated by LAMMPS (Large-scale Atomic/Molecular Massively Parallel Simulator). The coupling was achieved through the immersed boundary method (IBM). The code modeled both rigid and deformable solids exposed to flow. The code was validated with the Jeffery orbits of an ellipsoid particle in shear flow, red blood cell stretching test, and effective blood viscosity flowing in tubes. It demonstrated essentially linear scaling from 512 to 8192 cores for both strong and weak scaling cases. The computing time for the coupling increased with the solid fraction. An example of the fluid–solid coupling was given for flexible filaments (drug carriers) transport in flowing blood cell suspensions, highlighting the advantages and capabilities of the developed code.

Modeling thrombus formation and growth.

The paper reviews the state-of-the-art in computational modeling of thrombus formation and growth and related phenomena including platelet margination, activation, adhesion, and embolization. Presently, there is a high degree of empiricism in the modeling of thrombus formation. Based on the experimentally observed physics, the review gives useful strategies for predicting thrombus formation and growth. These include determining blood components involved in atherosclerosis, effective blood viscosity, tissue properties, and methods proposed for boundary conditions. In addition to the guidelines, ongoing research on the effect of shear stress on platelet margination, activation and adhesion, and platelet-surface interactions are reviewed. Biotechnol. Bioeng. 2017;114: 2154-2172. © 2017 Wiley Periodicals, Inc.

Abstract 372: The Endothelial Glycocalyx Promotes Homogenous Blood Flow Distribution within the Microvasculature

Introduction: Impaired tissue oxygenation is observed in many disease states including congestive heart failure, diabetes, cancer and aging. Decreased tissue perfusion and heterogeneous distribution of blood flow in the microvasculature contributes to this pathology. The physiological mechanisms regulating homogeneity/heterogeneity of microvascular perfusion are presently unknown. We hypothesized that microfluidic properties of the glycocalyx would promote perfusion homogeneity. Methods: To test our hypothesis, we used established empirical formulations for modelling blood viscosity in vivo (blood vessels) and in vitro (glass tubes). We first assess distribution of blood flow in idealized arteriolar networks. We next simulated distribution of blood flow at an idealized capillary bifurcation. Finally, we simulated velocity profiles and pressure gradients within the vessel lumen with varying glycocalyx properties using a computational fluid dynamics approach. Results: We found that transit time heterogeneity (as assessed by STD to mean ratio) was increased approximately 9x (6.9x-10.6x) using in vitro formulations of blood viscosity relative to in vivo formulations. This effect was mathematically accounted for by increased effective blood viscosity in smaller arterioles. We also found that distribution of blood flow at an idealized microvascular bifurcation was more symmetric using the in vivo formulation than the in vitro formulation (approximately 2x greater disparity between flow in downstream vessels). This effect was mathematically accounted for by an increased hematocrit dependence of blood viscosity. Both the diameter- and hematocrit-based changes in blood viscosity were entirely predictable from fluid dynamics simulations incorporating a space-filling, semi-permeable glycocalyx layer. Summary: Our simulations indicate that the mechanical properties of the endothelial glycocalyx promote homogeneous microvascular perfusion. Conclusions: The literature provides evidence of both glycocalyx degradation and impaired tissue perfusion in the same disease states. Preservation or restoration of normal glycocalyx properties may be a viable strategy for improving tissue perfusion in a wide variety of diseases.

Recovery of cell-free layer and wall shear stress profile symmetry downstream of an arteriolar bifurcation

Unequal RBC partitioning at arteriolar bifurcations contributes to dissimilar flow developments between daughter vessels in a bifurcation. Due to the importance of the cell-free layer (CFL) and the wall shear stress (WSS) to physiological processes such as vasoregulation and gas diffusion, we investigated the effects of a bifurcation disturbance on the development of the CFL width and WSS in bifurcation daughter branches. The analysis was performed on a two-dimensional (2-D) computational model of a transverse arteriole at three different flow rates corresponding to parent branch (PB) pseudoshear rates of 60, 170 and 470s−1, while maintaining a 2-D hematocrit of about 55% in the PB. Flow symmetry was defined using the statistical similarity of the CFL and WSS distributions between the two walls of the vessel branch. In terms of the flow symmetry recovery, higher flow rates caused larger reductions in the flow symmetry indices in the MB and subsequently required longer vessel lengths for complete recovery. Lower tube hematocrits in the SB led to complete symmetry recovery for all flow rates despite the higher initial asymmetry in the SB than in the MB. Arteriolar bifurcations produce unavoidable local CFL asymmetry and the persistence of the asymmetry downstream may increase effective blood viscosity which is especially significant at higher physiological flow rates.

Effect of blood viscosity and thrombus composition on sonoreperfusion efficacy

Embolization during stenting for myocardial infarction (MI) causes microvascular obstruction (MVO). We demonstrated that ultrasound (US) and microbubble (MB) therapy [sonoreperfusion (SRP)] resolves MVO from venous microthrombi at plasma viscosity. However, blood is more viscous than plasma, and arterial microthrombi are mechanically distinct from venous clot. We tested whether blood viscosity and arterial microthrombi decrease SRP efficacy in our in vitro model of MVO. Lipid MB in plasma and blood viscosity PBS were passed through a 40 μm pore mesh. Arterial microthrombi were formed in a Chandler loop. Venous microthrombi were made statically. MVO was created by occluding the mesh with microthrombi until upstream pressure reached 40 mmHg. US (1 MHz; 5000 cycles; 0.33 Hz PRF; 0.6, 1.0, and 1.5 MPa peak negative pressure) was delivered with a single focused element transducer. MVO caused by arterial thrombi at increased viscosity resulted in less upstream pressure drop during therapy. PCD showed a decrease in inertial cavitation (IC) when viscosity was increased. SRP efficacy is less with arterial thrombi compared to venous thrombi, and higher viscosity further reduces SRP efficacy by decreasing IC. These findings could help guide the selection of US parameters for in vivo optimization of SRP.

Differences Between Blood and a Newtonian Fluid on the Performance of a Hydrodynamic Bearing for Rotary Blood Pumps

Assuming that blood has a constant viscosity is a common practice when designing rotary blood pumps (RBPs), where shear stresses are generally higher than in the human body. This eases the design and allows numerical simulations and bench top experiments to be performed with Newtonian fluids. However, specific flow conditions may cause a change in cell distribution leading to an apparent lower blood viscosity. It has been observed that decreasing the vessel diameters and increasing flow velocities contribute to this effect. Because a hydrodynamic bearing operates under flow conditions following this pattern, it is important to verify whether this effect also takes place when this type of bearing is applied to a RBP. Because the operation of a hydrodynamic bearing depends directly on the fluid viscosity, a local change in cell distribution in the bearing gap can be reflected in changes in the bearing performance. In this work, a spiral groove hydrodynamic bearing was tested with porcine blood in a specially built test rig. The generated suspension force, cross flow, and bearing torque were recorded and compared with the reference response when using a solution of water and glycerol. Experiments with porcine blood yielded lower suspension forces, lower flows, and lower bearing torques than when using the glycerol solution. An explanation could be a lower apparent viscosity due to inhomogeneity of blood cell concentrations. Therefore, it is crucial to consider the effective blood viscosity when designing hydrodynamic bearings for RBPs and performing experiments.

STEM &amp; Health: Stressors on the circulatory system

The goal of these exercises is to understand the circulatory system while integrating STEM and health‐related issues. For high and middle school students the ability to assembly a model from a provided kit to represent the human circulatory system and relate the physics of how pressures are altered due to health related issues (obesity, arteriosclerosis) should promote the importance of why a healthy life style is advantageous. The hope is that providing cardiovascular kits to classrooms for teachers to use will bridge biology, physics and health concepts for an integrative approach to learning within STEM related around fluid dynamics and physiology. Four kits represent: (1) plaque formation and effect on flow, (2) elastic recoil and arteriosclerosis, (3) effects of blood viscosity, (4) differential blood pressure related to resistance. Since new national standards in teaching for secondary teachers in life sciences are to cover “modeling” as engineering and design, this activity is timely and very suited for a life science classroom for high &amp; middle schools as well as college level. In the four activities (kits), the alteration in the extant of circulatory “tubing” to flow and the effect of resistance on blood pressure can be modeled and experimented with by inquiry learning. Funded by KY Department of Education Science Leadership Support Network.

Blood viscosity as a forgotten factor and its effect on pulmonary flow.

BackgroundThe effect of smoking on blood viscosity is widely known. There are, however, few studies on the effect of blood viscosity on pulmonary circulation.MethodsWe aimed to observe the relationship between blood viscosity and pulmonary circulation among smokers and non-smokers. The study comprised 114 subjects in three groups: group 1, ex-smokers; group 2, smoked at least 10 packs/year and still smoking; group 3, never smoked. Blood viscosity (BV), pulmonary blood flow (PBF), and right ventricular systolic pressure (RVSP) were measured in all subjects.ResultsPBF was significantly lower in group 1 compared with group 3 (p < 0.05). BV in group 1 was significantly higher than group 3 (p < 0.05) while BV in group 2 was significantly higher than group 3 (p < 0.05). PBF in group 2 was significantly lower than group 3 (p = 0.01).ConclusionsWe believe that BV is a significant and forgotten factor that plays an important role in pulmonary and cardiovascular diseases. BV may affect PF even during the course of smoking, and before the clinical onset of chronic obstructive pulmonary disease (COPD). Therefore, individuals at risk of pulmonary hypertension could be detected earlier with a simple blood test.