title: A prototype paediatric venous cannula with shape change in situ.
abstract: During cardiopulmonary bypass (CPB), venous drainage may be impeded due to small vessel and cannula size or chattering, thus, blood return to the heart-lung machine is reduced. We designed a self-expandable prototype cannula, which is able to maintain the vein open and overcome this problem and analysed its performance capability. This prototype and several other cannulae were tested using an access vessel diameter of 7 mm. An in vitro circuit was set up with a 10 mm penrose latex tube simulating the patient's vein placed between the patient preload reservoir and the cannula, encasing the cannula's inlet(s). Maximum flow rate was determined for passive venous drainage (PVD) at preloads (P) of 2 and 4 mmHg. We compared these results to three classic single-stage venous cannulae: basket tip, thoracic drain and percutaneous tip. By comparing the other cannulae to the prototype, under PVD conditions and a central venous pressure (CVP) of 2 mmHg, the prototype cannula's flow rate (1.32 +/- 0.04 L/min) outperformed the basket type (the best performing comparator) (1.02 +/- 0.08 L/min) by 23% (p < 0.005). When the preload was increased to 4 mmHg under PVD conditions, the same trend was noted with the prototype cannula (1.65 +/- 0.05 L/min), outperforming the basket cannula's value (1.26 +/- 0.05 L/min) by 24% (p < 0.001). This new cannula design provides superior flow characteristics, under all test conditions, compared to the classic single-stage venous cannulae used for paediatric CPB surgery.
authors.affiliation: Department of Cardiovascular Surgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. David.Jegger@chuv.hospvd.ch
authors.forename: David
authors.initials: D
authors.lastname: Jegger
authors.forename: Antonio F
authors.initials: AF
authors.lastname: Corno
authors.forename: Antonio
authors.initials: A
authors.lastname: Mucciolo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mucciolo
authors.forename: Yves
authors.initials: Y
authors.lastname: Boone
authors.forename: Judith
authors.initials: J
authors.lastname: Horisberger
authors.forename: Isabelle
authors.initials: I
authors.lastname: Seigneul
authors.forename: Mirka
authors.initials: M
authors.lastname: Jachertz
authors.forename: Ludwig K
authors.initials: LK
authors.lastname: von Segesser
mesh_terms: D001783:Blood Flow Velocity; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002648:Child; D004867:Equipment Design; D019544:Equipment Failure Analysis; D018056:Hemorheology; D006801:Humans