Development of a superabsorber based haemofiltration technology for use in paediatric cardiac surgery

Cardiopulmonary bypass is known to cause great changes in a patient’s physiological fluidhomeostasis which frequently results in fluid accumulation in the interstitial space (edema). Theassociated inflammatory response can, in severe cases, result in systemic immune responsesyndrome, acute respiratory distress syndrome, and organ failure.Modified Ultrafiltration (MUF) involves pumping blood through a haemofilter post-bypass toremove excess plasma, and has been shown to successfully moderate haemodilution and theinflammatory response and improve clinical outcomes in paediatric patients for whom edema isa serious morbidity.In this research project, the current MUF technique is combined with a new superabsorberbased haemofiltration technology to develop a novel haemofiltration device.Design concepts were researched and the optimal device configuration was determined.Laboratory testing with bovine blood, computational modelling of blood flow and scanningelectron microscope imaging of the control membrane highlighted the importance of bothutilising flow disruption techniques to limit fouling, and controlling the swelling behaviour ofthe superabsorber material, in achieving rapid haemofiltration.The device is able to achieve passive, chemically driven haemofiltration at a fixed blood flowrate and is designed such that it requires minimal input from clinical staff to be suitable fordeployment in a clinical setting. The haemoconcentration time is close to current MUFprocedures but with further refinement of the system, equalling the MUF time for currentprocedures is certainly achievable.The blood haemoconcentrated by the device was of good quality with no significant change incell counts, cell morphology measures, or haemoglobin level measures after 60mins of MUFindicating little to no impact upon the blood constituents or haemolysis induced by the device.The device did not demonstrate selective removal of pro-inflammatory mediators but similarlythere was no increase in pro-inflammatory mediator concentrations observed. Furtherinvestigation of the inflammatory mediator impact is recommended.

Name dc:type.qualificationname

engd

Level dc:type.qualificationlevel

doctoral-pg

Grantor dc:publisher.institution

University of Strathclyde

Year dc:date.issued

2016

Author dc:creator

• Davis, Paul

Advisor dc:contributor.advisor

• Gourlay, Terry

DOI

10.48730/grpd-yc02

Identifier

T14441

Author Identifier

201080778

OAI identifier oai:identifier

oai:strathclyde:d217qp48j