Progress in the analysis of hemolysis and coagulation models for interventional micro-axial flow blood pumps_Journal of Biomedical Engineering

Authors：

WANG Shangting ¹ , FU Hualin ¹ , LU Zhexin ² ,  YANG Ming ¹

1. School of Electronic Information and Electrical Engineering, Shanghai Jiao Tong University, Shanghai 200240, P. R. China;
2. Department of Cardiovascular Surgery, Shanghai General Hospital, Shanghai 201620, P. R. China;

Corresponding author：

Keywords：

Axial flow blood pump; Hemolysis; Coagulation; Multi-scale model

DOI：

10.7507/1001-5515.202307050

Video：

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Interventional micro-axial flow blood pump is widely used as an effective treatment for patients with cardiogenic shock. Hemolysis and coagulation are vital concerns in the clinical application of interventional micro-axial flow pumps. This paper reviewed hemolysis and coagulation models for micro-axial flow blood pumps. Firstly, the structural characteristics of commercial interventional micro-axial flow blood pumps and issues related to clinical applications were introduced. Then the basic mechanisms of hemolysis and coagulation were used to study the factors affecting erythrocyte damage and platelet activation in interventional micro-axial flow blood pumps, focusing on the current models of hemolysis and coagulation on different scales (macroscopic, mesoscopic, and microscopic). Since models at different scales have different perspectives on the study of hemolysis and coagulation, a comprehensive analysis combined with multi-scale models is required to fully consider the influence of complex factors of interventional pumps on hemolysis and coagulation.

Citation： WANG Shangting, FU Hualin, LU Zhexin, YANG Ming. Progress in the analysis of hemolysis and coagulation models for interventional micro-axial flow blood pumps. Journal of Biomedical Engineering, 2024, 41(2): 383-388. doi: 10.7507/1001-5515.202307050 Copy

1.	中国医疗保健国际交流促进会急诊医学分会, 中华医学会急诊医学分会, 中国医师协会急诊医师分会,解放军急救医学专业委员会. 急性心力衰竭中国急诊管理指南(2022). 中国急救医学, 2022, 42(8): 648-670.
2.	李平, 徐博翎, 吴婷婷, 等. 体外心室辅助治疗心源性休克的临床应用现况. 临床心血管病杂志, 2021, 37(6): 500-507.
3.	Pahuja M, Hernandez-Montfort J, Whitehead E H, et al. Device profile of the Impella 5. 0 and 5.5 system for mechanical circulatory support for patients with cardiogenic shock: overview of its safety and efficacy. Expert Rev Med Devic, 2022, 19(1): 1-10.
4.	Mierke J, Loehn T, Ende G, et al. Percutaneous left ventricular assist device leads to heart rhythm stabilisation in cardiogenic shock: results from the Dresden Impella Registry. Heart Lung Circ, 2021, 30(4): 577-584.
5.	Wong A S K, Sin S W C. Short-term mechanical circulatory support (intra-aortic balloon pump, Impella, extracorporeal membrane oxygenation, TandemHeart): a review. Ann Transl Med, 2020, 8(13): 829.
6.	De Potter T, Valeriano C, Buytaert D, et al. Noninvasive neurological monitoring to enhance pLVAD-assisted ventricular tachycardia ablation - a Mini review. Front Cardiovasc Med, 2023, 10: 1140153.
7.	Li Y, Wang H, Xi Y, et al. Multi-indicator analysis of mechanical blood damage with five clinical ventricular assist devices. Comput Biol Med, 2022, 151: 106271.
8.	Roka-Moiia Y, Li M, Ivich A, et al. Impella 5. 5 versus Centrimag: A head-to-head comparison of device hemocompatibility. ASAIO J, 2020, 66(10): 1142-1151.
9.	Badiye A P, Hernandez G A, Novoa I, et al. Incidence of hemolysis in patients with cardiogenic shock treated with Impella percutaneous left ventricular assist device. ASAIO J, 2016, 62(1): 11-14.
10.	Attinger-Toller A, Bossard M, Cioffi G M, et al. Ventricular unloading using the Impella(TM) device in cardiogenic shock. Front Cardiovasc Med, 2022, 9: 856870.
11.	Vandenbriele C, Arachchillage Deepa J, Frederiks P, et al. Anticoagulation for percutaneous ventricular assist device-supported cardiogenic shock. J Am Coll Cardiol, 2022, 79(19): 1949-1962.
12.	Wu P, Gao Q, Hsu P L. On the representation of effective stress for computing hemolysis. Biomech Model Mechan, 2019, 18(3): 665-679.
13.	国家市场监督管理总局, 国家标准化管理委员会. 医疗器械生物学评价第4部分: 与血液相互作用试验选择: GB/T 16886.4-2022. 北京: 中国标准出版社, 2022: 68.
14.	Tian Y, Tian Z, Dong Y, et al. Current advances in nanomaterials affecting morphology, structure, and function of erythrocytes. RSC Adv, 2021, 11(12): 6958-6971.
15.	Papanastasiou C A, Kyriakoulis K G, Theochari C A, et al. Comprehensive review of hemolysis in ventricular assist devices. World J Cardiol, 2020, 12(7): 334-341.
16.	McNamee A P, Simmonds M J. Red blood cell sublethal damage: Hemocompatibility is not the absence of hemolysis. Transfus Med Rev, 2023, 37(2): 150723.
17.	Kameneva M V, Burgreen G W, Kono K, et al. Effects of turbulent stresses upon mechanical hemolysis: experimental and computational analysis. ASAIO J, 2004, 50(5): 418.
18.	唐洁, 程云章, 郑淇文, 等. 介入式微型轴流血泵溶血机理及影响因素分析. 中国医学物理学杂志, 2020, 37(3): 368-373.
19.	曹伟. 血液保护学. 杭州: 浙江大学出版社, 2008.
20.	Gorbet M B, Sefton M V. Biomaterial-associated thrombosis: roles of coagulation factors, complement, platelets and leukocytes. Biomaterials, 2004, 25(26): 5681-5703.
21.	符珉瑞, 高斌, 常宇, 等. 血流动力学优化在人工心脏设计中的应用. 生物医学工程学杂志, 2020, 37(6): 1000-1011.
22.	Yu H, Engel S, Janiga G, et al. A review of hemolysis prediction models for computational fluid dynamics. Artif Organs, 2017, 41(7): 603-621.
23.	Giersiepen M, Wurzinger L J, Opitz R, et al. Estimation of shear stress-related blood damage in heart valve prostheses - in vitro comparison of 25 aortic valves. Int J Artif Organs, 1990, 13(5): 300-306.
24.	Wurzinger L, Opitz R, Blasberg P, et al. Platelet and coagulation parameters following millisecond exposure to laminar shear stress. Thromb Haemost, 1985, 54(6): 381-386.
25.	Yun Z, Yao J, Wang L, et al. The design and evaluation of the outflow structures of an interventional microaxial blood pump. Front Physiol, 2023, 14: 1169905.
26.	Apel J, Paul R, Klaus S, et al. Assessment of hemolysis related quantities in a microaxial blood pump by computational fluid dynamics. Artif Organs, 2001, 25(5): 341-347.
27.	Zhang P, Gao C, Zhang N, et al. Multiscale particle-based modeling of flowing platelets in blood plasma using dissipative particle dynamics and coarse grained molecular dynamics. Cell Mol Bioeng, 2014, 7(4): 552-574.
28.	Xu Z, Wang C, He F, et al. Coarse-grained model of whole blood hemolysis and morphological analysis of erythrocyte population under non-physiological shear stress flow environment. Phys Fluids, 2023, 35(3): 031901.
29.	Ma S, Wang S, Qi X, et al. Multiscale computational framework for predicting viscoelasticity of red blood cells in aging and mechanical fatigue. Comput Methods Appl Mech Eng, 2022, 391: 114535.
30.	Xu Z, Chen C, Hao P, et al. Cell-scale hemolysis evaluation of intervenient ventricular assist device based on dissipative particle dynamics. Front Physiol, 2023, 14: 1181423.
31.	Torner B, Frank D, Grundmann S, et al. Flow simulation-based particle swarm optimization for developing improved hemolysis models. Biomech Model Mechanobiol, 2023, 22(2): 401-416.
32.	Down L A, Papavassiliou D V, O’Rear E A. Significance of extensional stresses to red blood cell lysis in a shearing flow. Ann Biomed Eng, 2011, 39(6): 1632-1642.
33.	Sohrabi S, Liu Y. A cellular model of shear-induced hemolysis. Artif Organs, 2017, 41(9): E80-E91.
34.	Nikfar M, Razizadeh M, Zhang J, et al. Prediction of mechanical hemolysis in medical devices via a Lagrangian strain-based multiscale model. Artif Organs, 2020, 44(8): E348-E368.
35.	Manning K B, Nicoud F, Shea S M. Mathematical and computational modeling of device-induced thrombosis. Curr Opin Biomed Eng, 2021, 20: 100349.
36.	Blum C, Groß-Hardt S, Steinseifer U, et al. An accelerated thrombosis model for computational fluid dynamics simulations in rotary blood pumps. Cardiovasc Eng Techn, 2022, 13(4): 638-649.
37.	Li Y, Wang H, Xi Y, et al. A new mathematical numerical model to evaluate the risk of thrombosis in three clinical ventricular assist devices. Bioengineering, 2022, 9(6): 235.
38.	Beavers C J, Didomenico R J, Dunn S P, et al. Optimizing anticoagulation for patients receiving Impella support. Pharmacotherapy, 2021, 41(11): 932-942.
39.	Zhu Y, Han C, Zhang P, et al. AI-aided multiscale modeling of physiologically-significant blood clots. Comput Phys Commun, 2023, 287: 108718.
40.	Gupta P, Zhang P, Sheriff J, et al. A multiscale model for multiple platelet aggregation in shear flow. Biomech Model Mechan, 2021, 20(3): 1013-1030.
41.	Ye T, Shi H, Phan-Thien N, et al. The key events of thrombus formation: platelet adhesion and aggregation. Biomech Model Mechan, 2020, 19(3): 943-955.
42.	Monteleone A, Viola A, Napoli E, et al. Modelling of thrombus formation using smoothed particle hydrodynamics method. PLoS One, 2023, 18(2): e0281424.
43.	Xu Z, Chen N, Kamocka M M, et al. A multiscale model of thrombus development. J R Soc Interface, 2007, 5(24): 705-722.
44.	Zhang P, Zhou X, Jiang J, et al. In situ analysis of membrane-protein binding kinetics and cell–surface adhesion using plasmonic scattering microscopy. Angew Chem Int Ed Engl, 2022, 61(42): e202209469.
45.	Yazdani A, Deng Y, Li H, et al. Integrating blood cell mechanics, platelet adhesive dynamics and coagulation cascade for modelling thrombus formation in normal and diabetic blood. J R Soc Interface, 2021, 18(175): 20200834.

1. 中国医疗保健国际交流促进会急诊医学分会, 中华医学会急诊医学分会, 中国医师协会急诊医师分会,解放军急救医学专业委员会. 急性心力衰竭中国急诊管理指南(2022). 中国急救医学, 2022, 42(8): 648-670.
2. 李平, 徐博翎, 吴婷婷, 等. 体外心室辅助治疗心源性休克的临床应用现况. 临床心血管病杂志, 2021, 37(6): 500-507.
3. Pahuja M, Hernandez-Montfort J, Whitehead E H, et al. Device profile of the Impella 5. 0 and 5.5 system for mechanical circulatory support for patients with cardiogenic shock: overview of its safety and efficacy. Expert Rev Med Devic, 2022, 19(1): 1-10.
4. Mierke J, Loehn T, Ende G, et al. Percutaneous left ventricular assist device leads to heart rhythm stabilisation in cardiogenic shock: results from the Dresden Impella Registry. Heart Lung Circ, 2021, 30(4): 577-584.
5. Wong A S K, Sin S W C. Short-term mechanical circulatory support (intra-aortic balloon pump, Impella, extracorporeal membrane oxygenation, TandemHeart): a review. Ann Transl Med, 2020, 8(13): 829.
6. De Potter T, Valeriano C, Buytaert D, et al. Noninvasive neurological monitoring to enhance pLVAD-assisted ventricular tachycardia ablation - a Mini review. Front Cardiovasc Med, 2023, 10: 1140153.
7. Li Y, Wang H, Xi Y, et al. Multi-indicator analysis of mechanical blood damage with five clinical ventricular assist devices. Comput Biol Med, 2022, 151: 106271.
8. Roka-Moiia Y, Li M, Ivich A, et al. Impella 5. 5 versus Centrimag: A head-to-head comparison of device hemocompatibility. ASAIO J, 2020, 66(10): 1142-1151.
9. Badiye A P, Hernandez G A, Novoa I, et al. Incidence of hemolysis in patients with cardiogenic shock treated with Impella percutaneous left ventricular assist device. ASAIO J, 2016, 62(1): 11-14.
10. Attinger-Toller A, Bossard M, Cioffi G M, et al. Ventricular unloading using the Impella(TM) device in cardiogenic shock. Front Cardiovasc Med, 2022, 9: 856870.
11. Vandenbriele C, Arachchillage Deepa J, Frederiks P, et al. Anticoagulation for percutaneous ventricular assist device-supported cardiogenic shock. J Am Coll Cardiol, 2022, 79(19): 1949-1962.
12. Wu P, Gao Q, Hsu P L. On the representation of effective stress for computing hemolysis. Biomech Model Mechan, 2019, 18(3): 665-679.
13. 国家市场监督管理总局, 国家标准化管理委员会. 医疗器械生物学评价第4部分: 与血液相互作用试验选择: GB/T 16886.4-2022. 北京: 中国标准出版社, 2022: 68.
14. Tian Y, Tian Z, Dong Y, et al. Current advances in nanomaterials affecting morphology, structure, and function of erythrocytes. RSC Adv, 2021, 11(12): 6958-6971.
15. Papanastasiou C A, Kyriakoulis K G, Theochari C A, et al. Comprehensive review of hemolysis in ventricular assist devices. World J Cardiol, 2020, 12(7): 334-341.
16. McNamee A P, Simmonds M J. Red blood cell sublethal damage: Hemocompatibility is not the absence of hemolysis. Transfus Med Rev, 2023, 37(2): 150723.
17. Kameneva M V, Burgreen G W, Kono K, et al. Effects of turbulent stresses upon mechanical hemolysis: experimental and computational analysis. ASAIO J, 2004, 50(5): 418.
18. 唐洁, 程云章, 郑淇文, 等. 介入式微型轴流血泵溶血机理及影响因素分析. 中国医学物理学杂志, 2020, 37(3): 368-373.
19. 曹伟. 血液保护学. 杭州: 浙江大学出版社, 2008.
20. Gorbet M B, Sefton M V. Biomaterial-associated thrombosis: roles of coagulation factors, complement, platelets and leukocytes. Biomaterials, 2004, 25(26): 5681-5703.
21. 符珉瑞, 高斌, 常宇, 等. 血流动力学优化在人工心脏设计中的应用. 生物医学工程学杂志, 2020, 37(6): 1000-1011.
22. Yu H, Engel S, Janiga G, et al. A review of hemolysis prediction models for computational fluid dynamics. Artif Organs, 2017, 41(7): 603-621.
23. Giersiepen M, Wurzinger L J, Opitz R, et al. Estimation of shear stress-related blood damage in heart valve prostheses - in vitro comparison of 25 aortic valves. Int J Artif Organs, 1990, 13(5): 300-306.
24. Wurzinger L, Opitz R, Blasberg P, et al. Platelet and coagulation parameters following millisecond exposure to laminar shear stress. Thromb Haemost, 1985, 54(6): 381-386.
25. Yun Z, Yao J, Wang L, et al. The design and evaluation of the outflow structures of an interventional microaxial blood pump. Front Physiol, 2023, 14: 1169905.
26. Apel J, Paul R, Klaus S, et al. Assessment of hemolysis related quantities in a microaxial blood pump by computational fluid dynamics. Artif Organs, 2001, 25(5): 341-347.
27. Zhang P, Gao C, Zhang N, et al. Multiscale particle-based modeling of flowing platelets in blood plasma using dissipative particle dynamics and coarse grained molecular dynamics. Cell Mol Bioeng, 2014, 7(4): 552-574.
28. Xu Z, Wang C, He F, et al. Coarse-grained model of whole blood hemolysis and morphological analysis of erythrocyte population under non-physiological shear stress flow environment. Phys Fluids, 2023, 35(3): 031901.
29. Ma S, Wang S, Qi X, et al. Multiscale computational framework for predicting viscoelasticity of red blood cells in aging and mechanical fatigue. Comput Methods Appl Mech Eng, 2022, 391: 114535.
30. Xu Z, Chen C, Hao P, et al. Cell-scale hemolysis evaluation of intervenient ventricular assist device based on dissipative particle dynamics. Front Physiol, 2023, 14: 1181423.
31. Torner B, Frank D, Grundmann S, et al. Flow simulation-based particle swarm optimization for developing improved hemolysis models. Biomech Model Mechanobiol, 2023, 22(2): 401-416.
32. Down L A, Papavassiliou D V, O’Rear E A. Significance of extensional stresses to red blood cell lysis in a shearing flow. Ann Biomed Eng, 2011, 39(6): 1632-1642.
33. Sohrabi S, Liu Y. A cellular model of shear-induced hemolysis. Artif Organs, 2017, 41(9): E80-E91.
34. Nikfar M, Razizadeh M, Zhang J, et al. Prediction of mechanical hemolysis in medical devices via a Lagrangian strain-based multiscale model. Artif Organs, 2020, 44(8): E348-E368.
35. Manning K B, Nicoud F, Shea S M. Mathematical and computational modeling of device-induced thrombosis. Curr Opin Biomed Eng, 2021, 20: 100349.
36. Blum C, Groß-Hardt S, Steinseifer U, et al. An accelerated thrombosis model for computational fluid dynamics simulations in rotary blood pumps. Cardiovasc Eng Techn, 2022, 13(4): 638-649.
37. Li Y, Wang H, Xi Y, et al. A new mathematical numerical model to evaluate the risk of thrombosis in three clinical ventricular assist devices. Bioengineering, 2022, 9(6): 235.
38. Beavers C J, Didomenico R J, Dunn S P, et al. Optimizing anticoagulation for patients receiving Impella support. Pharmacotherapy, 2021, 41(11): 932-942.
39. Zhu Y, Han C, Zhang P, et al. AI-aided multiscale modeling of physiologically-significant blood clots. Comput Phys Commun, 2023, 287: 108718.
40. Gupta P, Zhang P, Sheriff J, et al. A multiscale model for multiple platelet aggregation in shear flow. Biomech Model Mechan, 2021, 20(3): 1013-1030.
41. Ye T, Shi H, Phan-Thien N, et al. The key events of thrombus formation: platelet adhesion and aggregation. Biomech Model Mechan, 2020, 19(3): 943-955.
42. Monteleone A, Viola A, Napoli E, et al. Modelling of thrombus formation using smoothed particle hydrodynamics method. PLoS One, 2023, 18(2): e0281424.
43. Xu Z, Chen N, Kamocka M M, et al. A multiscale model of thrombus development. J R Soc Interface, 2007, 5(24): 705-722.
44. Zhang P, Zhou X, Jiang J, et al. In situ analysis of membrane-protein binding kinetics and cell–surface adhesion using plasmonic scattering microscopy. Angew Chem Int Ed Engl, 2022, 61(42): e202209469.
45. Yazdani A, Deng Y, Li H, et al. Integrating blood cell mechanics, platelet adhesive dynamics and coagulation cascade for modelling thrombus formation in normal and diabetic blood. J R Soc Interface, 2021, 18(175): 20200834.

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