Effect of blood viscosity on the performance of virtually wall-less venous cannulas.

Aim: This study was designed to quantify the influence of blood as test medium compared to water in cannula bench performance assessment. Methods: An in vitro circuit was set-up with silicone tubing between two reservoirs. The test medium was pumped from the lower reservoir by centrifugal pump to the upper reservoir. The test-cannula was inserted in a silicone tube connected between the lower reservoir and the centrifugal pump. Flow rate and pump inlet-pressure were measured for wall-less versus thin-wall cannula using a centrifugal pump in a dynamic bench-test for an afterload of 40-60 mmHg using two media: blood 10 g/dL and 5.6 g/dL and water 0 g/dL. Results: The wall-less cannula showed significantly higher flows rates as compared to the thin-wall cannula (control), with both hemoglobin concentrations and water. Indeed, for a target volume of 200-250 mL of blood (Hg 10 g/dL) in the upper reservoir, the cannula outlet pressure (P) was -14 +/- 14 mmHg versus -18 +/- 11 mmHg for the wall-less and control respectively; the cannula outlet flow rate (Q) was 3.91 +/- 0.41 versus 3.67 +/- 0.45 L/min, respectively. At the same target volume but with a Hg of 5.7 g/dL, P was -16 +/- 12 mmHg versus -19 +/- 12 mmHg and Q was 4 +/- 0.1 versus 4 +/- 0.4 L/min for the wall-less cannula and control respectively. Likewise, P and Q values with water were -1 mmHg versus -0.67 +/- 0.58 mmHg and 4.17 +/- 0.45 L/min versus 4.08 +/- 0.47 L/min for the wall-less and control respectively. Conclusion: Walls-less cannula showed 5.6% less pump inlet-pressure differences calculated between blood and water, as compared to that of thin-wall cannula (-21 times). Flow differences were 6% and 10% for the walls-less and thin-wall cannula respectively. We conclude that testing the cannula performance with water is a good scenario and can overestimate the flow by a 10%. However, superiority for wall-less is preserved with both water and blood.