The blood heat exchanger in intra-arterial selective cooling infusion for acute ischemic stroke: A computational fluid-thermodynamics performance, experimental assessment and evaluation on the brain temperature. (June 2022)

• Record Type: Journal Article
• Authors: Jiang, Miaowen; Gao, Yuan; Wu, Chuanjie; Wu, Longfei; Tang, Shoucheng; Yin, Zhichen; Li, Ang; Wang, Kun; Zheng, Shiqiang; Lee, Hangil; Ding, Yuchuan; Li, Ming; Ji, Xunming
• Is Part Of: Computers in biology and medicine. Volume 145(2022)
• Publication Date: 2022-06
• Subjects: Blood heat exchanger -- Therapeutic hypothermia -- Stroke -- Hemolysis -- Numerical simulation; Medicine -- Data processing -- Periodicals; Biology -- Data processing -- Periodicals; 610.285
• DOI: 10.1016/j.compbiomed.2022.105497
• Languages: English
• ISSNs: 0010-4825

Abstract

Abstract: Intra-arterial selective cooling infusion with the autologous blood (IA-SCAI) is a promising therapeutic hypothermia induction method for conferring neuroprotection to acute ischemic stroke (AIS) patients. The blood heat exchanger (BHE) plays a crucial role in IA-SCAI's cooling capacity. However, there are no BHEs currently available that are specifically designed for the IA-SCAI, which requires a low blood flow to be compatible with cerebral hemodynamics. In an effort to develop a BHE for AIS patients, a prototype of a commercial BHE, Medtronic MYOtherm XP®, was mathematically modeled; specifically, computational fluid dynamics (CFD) was used to analyze its hemo- and thermo-dynamic characteristics under low blood flow including temperature distribution, velocity field and shear stress. Our numerical model predicted the hemolysis index to be 0.0041%–0.0581% inside the BHE with blood flows rates of 10 ml min −1 –50 ml min −1 . The in vitro heat transfer experiment showed that the BHE efficiently cooled the simulated blood from the initial 37 °C–5.8 °C within 150 s by using cold water (200 ml·min-1, 0 °C). The cooled simulated blood was able to cool the simulated blood in the middle cerebral artery of an artificial circulating system from 37 °C to 16.8 °C–33.7 °C depending on the blood perfusion rate (10–50 ml/min). A biological heat transfer mathematical model showed that brain tissue could be cooled by 2 °C within the initial 1min of infusion. This study verified the feasibility of using a commercial BHE for IA-SCAI and provided insights into its cooling capacity for therapeutic hypothermia. Highlights: Intra-arterial selective cooling infusion with auto-blood is a promising therapeutic hypothermia method for neuroprotection. A blood heat exchanger was investigated to achieve high cooling efficiency and low hemolysis index by numerical simulations. The in vitro experiment showed the BHE cooled simulated blood from initial 37°C to 5.8°C within 150s by cold water. A biological heat mathematical model showed that brain tissue could be cooled by 2℃ within the initial 1min of infusion.