Effect of Roller Pump Pulse in the Arterial Needle Area during Hemodialysis

Vascular access is a lifeline for hemodialysis patients. Its lifetime is affected by many hemodynamic factors such as pressure, flow regime and wall shear stress. During hemodialysis, changes in hemodynamic parameters occur due to the flow from needles inserted into the vascular system. Primarily, t...

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Autores principales:	Milos Kasparek, Ludmila Novakova, Jan Malik
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	hemodialysis wall shear stress peristaltic pump particle image velocimetry method Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/0570dc5f03d645cd87d5d4507a5a42c5
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spelling	oai:doaj.org-article:0570dc5f03d645cd87d5d4507a5a42c52021-11-25T17:20:43ZEffect of Roller Pump Pulse in the Arterial Needle Area during Hemodialysis10.3390/diagnostics111120102075-4418https://doaj.org/article/0570dc5f03d645cd87d5d4507a5a42c52021-10-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2010https://doaj.org/toc/2075-4418Vascular access is a lifeline for hemodialysis patients. Its lifetime is affected by many hemodynamic factors such as pressure, flow regime and wall shear stress. During hemodialysis, changes in hemodynamic parameters occur due to the flow from needles inserted into the vascular system. Primarily, there is a change in shear stress that affects the vascular wall. Pathological effects of high or low WSS are known. The effect of jet from a venous needle on hemodynamics parameters was studied, but the influence of the arterial needle on hemodynamics parameters is not sufficiently studied. To understand its possible effects, we performed in vivo and in vitro studies. Methods. In vivo experiment: The existence of flow reversal around the suction needle was visualized in a group of 12 randomly selected patients using ultrasound velocity profiling (Doppler ultrasonography) during hemodialysis. In vitro experiment: The flow field was measured using the stereo particle image velocimetry method (stereo PIV). Two regimes were studied. In the first regime, the fluid in the extracorporeal circuit was pumped by a peristaltic pump. In the second regime, the continuous pump was used in the extracorporeal circuit. The conditions were set to resemble those in vascular access during a hemodialysis session. Flow volume was set to 600 mL/min for vascular access and 200 mL/min for the extracorporeal circuit. Results. The main finding of this study was that the wall in the region of the arterial needle was stressed by backflow through the arterial needle. Since this was a variable, low-shear stress loading, it was one of the risk factors for the development of stenosis. Cyclic flow reversal was apparent in all of the included hemodialysis patients. The stereo PIV in vitro experiment revealed the oscillating character of wall shear stress (WSS) inside the model. High shear stress was documented upstream of the injection point of the arterial needle. An area of very low WSS was detected right behind the injection point during a pulse of the peristaltic pump. The minimal and maximal values of the WSS during a pulse of the peristaltic pump in the observed area were −0.7 Pa and 6 Pa, respectively. The distribution of wall shear stress with the continual pump used in the extracorporeal circuit was similar to the distribution during a pulse of the peristaltic one. However, the WSS values were continual; the WSS did not oscillate. WSS ranged between 4.8 Pa and 1.0 Pa.Milos KasparekLudmila NovakovaJan MalikMDPI AGarticlehemodialysiswall shear stressperistaltic pumpparticle image velocimetry methodMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2010, p 2010 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hemodialysis wall shear stress peristaltic pump particle image velocimetry method Medicine (General) R5-920
spellingShingle	hemodialysis wall shear stress peristaltic pump particle image velocimetry method Medicine (General) R5-920 Milos Kasparek Ludmila Novakova Jan Malik Effect of Roller Pump Pulse in the Arterial Needle Area during Hemodialysis
description	Vascular access is a lifeline for hemodialysis patients. Its lifetime is affected by many hemodynamic factors such as pressure, flow regime and wall shear stress. During hemodialysis, changes in hemodynamic parameters occur due to the flow from needles inserted into the vascular system. Primarily, there is a change in shear stress that affects the vascular wall. Pathological effects of high or low WSS are known. The effect of jet from a venous needle on hemodynamics parameters was studied, but the influence of the arterial needle on hemodynamics parameters is not sufficiently studied. To understand its possible effects, we performed in vivo and in vitro studies. Methods. In vivo experiment: The existence of flow reversal around the suction needle was visualized in a group of 12 randomly selected patients using ultrasound velocity profiling (Doppler ultrasonography) during hemodialysis. In vitro experiment: The flow field was measured using the stereo particle image velocimetry method (stereo PIV). Two regimes were studied. In the first regime, the fluid in the extracorporeal circuit was pumped by a peristaltic pump. In the second regime, the continuous pump was used in the extracorporeal circuit. The conditions were set to resemble those in vascular access during a hemodialysis session. Flow volume was set to 600 mL/min for vascular access and 200 mL/min for the extracorporeal circuit. Results. The main finding of this study was that the wall in the region of the arterial needle was stressed by backflow through the arterial needle. Since this was a variable, low-shear stress loading, it was one of the risk factors for the development of stenosis. Cyclic flow reversal was apparent in all of the included hemodialysis patients. The stereo PIV in vitro experiment revealed the oscillating character of wall shear stress (WSS) inside the model. High shear stress was documented upstream of the injection point of the arterial needle. An area of very low WSS was detected right behind the injection point during a pulse of the peristaltic pump. The minimal and maximal values of the WSS during a pulse of the peristaltic pump in the observed area were −0.7 Pa and 6 Pa, respectively. The distribution of wall shear stress with the continual pump used in the extracorporeal circuit was similar to the distribution during a pulse of the peristaltic one. However, the WSS values were continual; the WSS did not oscillate. WSS ranged between 4.8 Pa and 1.0 Pa.
format	article
author	Milos Kasparek Ludmila Novakova Jan Malik
author_facet	Milos Kasparek Ludmila Novakova Jan Malik
author_sort	Milos Kasparek
title	Effect of Roller Pump Pulse in the Arterial Needle Area during Hemodialysis
title_short	Effect of Roller Pump Pulse in the Arterial Needle Area during Hemodialysis
title_full	Effect of Roller Pump Pulse in the Arterial Needle Area during Hemodialysis
title_fullStr	Effect of Roller Pump Pulse in the Arterial Needle Area during Hemodialysis
title_full_unstemmed	Effect of Roller Pump Pulse in the Arterial Needle Area during Hemodialysis
title_sort	effect of roller pump pulse in the arterial needle area during hemodialysis
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/0570dc5f03d645cd87d5d4507a5a42c5
work_keys_str_mv	AT miloskasparek effectofrollerpumppulseinthearterialneedleareaduringhemodialysis AT ludmilanovakova effectofrollerpumppulseinthearterialneedleareaduringhemodialysis AT janmalik effectofrollerpumppulseinthearterialneedleareaduringhemodialysis
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Effect of Roller Pump Pulse in the Arterial Needle Area during Hemodialysis

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