Development of an intravenous oxygenator

Elson, Wesley De Vere (2014-04)

Thesis (MScEng)--Stellenbosch University, 2014.

Thesis

ENGLISH ABSTRACT: Patients in critical care with lung injuries need to be assisted with regards to breathing function, but current methods are not applicable for all situations. The most common method, Extracorporeal Membrane Oxygenation (ECMO) is an expensive procedure and requires trained staff to operate the equipment at all times. Lung injury may lead to the inability of the lungs to be perfused and the blood oxygenated by tracheal intubation, whereas mechanical ventilators can injure the lungs further. Especially at risk are preterm neonates, where congenital disorders or complications during birth render ECMO the only viable option. Respiratory Assist Catheters (RACs) could be used as an alternative because they do not place extra stress on the lungs, are easy to implement, cost-effective and are available for immediate use in clinical settings or in first aid situations. The development of such a device requires knowledge of possible oxygenation methods as well as the risks involved in implementing such a device. The possibility of oxygenating the blood via microbubbles by means of a RAC is promising due to the high gas transfer rates common in bubble oxygenators. It is the aim of this study to develop a prototype that could function as a RAC and to evaluate the feasibility of oxygenation by using microbubbles. The method used to design a prototype included selection of various materials and finalization of a design to be tested. The tests selected were in vivo tests and ex vivo tests using animal models to investigate the dissolution times of the microbubbles, as well as the physiological effects of an intravenously placed device. Measurements of oxygen saturation of the blood in arterial blood (SaO2), venous blood (SvO2) and pulmonary pressure allowed the oxygen transfer rates and risks involved to be evaluated, and also gave an indication regarding the formation dynamics of microbubbles in the blood. An in vitro test was also performed with the aim of determining the rate of dissolving of oxygen, and hence to give an indication regarding microbubble dissolution times. Mathematical simulations based on the dissolution rate of oxygen in venous blood confirmed the abovementioned results. The tests and simulations were analysed in order to evaluate the feasibility of intravenously oxygenating the blood using microbubbles. Approximate bubble dissolution times were an indicator of the feasibility of the concept and showed that very large bubble dissolution times renders intravenous bubble oxygenation unfeasible. These large dissolution times also lessen the possibility of implementing bubble oxygenation in an intravenous device.

AFRIKAANSE OPSOMMING: Pasiënte wat a.g.v. longbeserings in hoë-sorg behandel word het hulp nodig om asem te haal, maar bestaande metodes werk nie in alle omstandighede nie. Die mees algemene metode is ekstrakorporeale membraan suurstofverbinding (Extracorporeal Membrane Oxygenation (ECMO)), maar hierdie metode is duur en het voltyds opgeleide personeel nodig om dit te beheer. Longbeserings kan lei tot die onvermoë van die longe om bloed te ontvang en ook dat die bloed suurstof kry d.m.v. trageale intubasie. Meganiese ventilators kan die longe verder beskadig. Vroeggebore babas word blootgestel aan risiko’s veral waar oorerflike afwykings/steurnisse aanwesig is of komplikasies tydens geboorte en dus die EMCO die enigste lewensvatbare opsie maak. Kateters wat asemhaling aanhelp (Respiratory Assist Catheters (RACs)) kan as alternatief gebruik word aangesien dit nie ekstra spanning op die longe plaas nie, maklik is om te implementeer, koste-effektief is en beskikbaar is vir onmiddellike gebruik in kliniese omstandighede of in noodhulpsituasies. Die ontwikkeling van hierdie tipe toestel vereis kennis van moontlike suurstofverbindingsmetodes en ook die risiko’s verbonde aan die implementering van die toestel. Die moontlikheid om die bloed van suurstof te voorsien d.m.v. mikroborrels deur die RAC lyk belowend a.g.v. die hoë gasoordrag-koers wat algemeen is by borrel suurstofverbinders. Hierdie studie het ten doel om ʼn prototipe te ontwikkel wat kan dien as ʼn RAC en ook om die lewensvatbaarheid van suurstofverbinding met mikroborrels te bepaal. Die metode wat gebruik is om die prototipe te ontwerp sluit in die kies van verskeie materiale en die finalisering van die ontwerp wat getoets moet word. Die geselekteerde in vivo en ex vivo toetse is afgeneem deur gebruik te maak van dier-modelle om sodoende ondersoek in te stel na die oplossing van die mikroborrels en ook die fisiologiese gevolge van die toestel wat binne die aar geplaas is. Metings van die suurstofversadiging van bloed in slagaarbloed (SaO2), aarbloed (SvO2) en pulmonêre druk het toegelaat dat die koers en risiko’s verbonde aan suurstofoordrag geëvalueer word. Hierdie metings gee ook ’n aanduiding van die vormingsdinamika van die mikroborrels in die bloed. ’n In vitro toets is gedoen met die doel om die koers te bepaal van die oplossing van suurstof, en dus ’n aanduiding te gee van die tyd verbonde aan die oplossing van die mikroborrels. Wiskundige simulasies gebaseer op die oplossingskoers van suurstof in are het die bogenoemde toetse bevestig. Die toetse en simulasies is geanaliseer om die lewensvatbaarheid te bepaal om suurstof binne-aars te verskaf deur mikroborrels. Geskatte tye waarteen die borrels oplos is as aanduiding gebruik vir die lewensvatbaarheid van die konsep en ook die moontlike inwerkingstelling van die binne-aarse toestel.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/86494
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