The effect of shear, specific surface, and air interface on the development of blood emboli and hemolysis

Abstract
Heparinized dog blood was exposed to shear and foreign surfaces in conicylindrical test cells. The cells were injection molded from polycarbonate and were filled using a technique that avoided contact of the blood with air. Particulate-matter formation was measured and was found to be dominated by the surface-to-blood–volume ratio and to be independent of shear rate. Hemolysis was also measured and was found to vary linearly with shear rate and to increase with increasing surface-to-blood volume ratio. Thus, at low shear rates and high specific surface conditions, the degree of hemolysis was found to be minimal while particulate-matter formation was high. The results suggest that the safety of extracorporeal perfusion procedures cannot be inferred from hemolysis measurements alone. In one series of tests, a gas–blood interface was generated at a rate equivalent to the rate of surface renewal in conventional disc oxygenators. The gas–blood interface failed to contribute significantly to the damage indices, which suggests that the apparent superiority of membrane oxygenators may be a result of factors other than the absence of a blood–gas interface.