0
Research Papers

A Novel Macroscale Acoustic Device for Blood Filtration

[+] Author and Article Information
Brian Dutra, Bart Lipkens

College of Engineering,
Western New England University,
Springfield, MA 01119;
Flo Design Sonics Inc.,
Wilbraham, MA 01095

Maria Carmen Mora, Katharine R. Bittner, Michael V. Tirabassi

Department of Surgery,
University of Massachusetts Medical
School-Baystate,
Springfield, MA 01109

Tyler I. Gerhardson, Brianna Sporbert, Michael J. Rust

College of Engineering,
Western New England University,
Springfield, MA 01119

Alexandre Dufresne, Carolanne Lovewell

Baystate Research Facility,
University of Massachusetts Medical
School-Baystate,
Springfield, MA 01109

Louis Masi

Flo Design Sonics Inc.,
Wilbraham, MA 01095

Daniel R. Kennedy

College of Pharmacy,
Western New England University,
1215 Wilbraham Road,
Springfield, MA 01119
e-mail: dkennedy@wne.edu

1Corresponding author.

Manuscript received July 21, 2017; final manuscript received November 7, 2017; published online January 19, 2018. Assoc. Editor: Matthew R. Myers.

J. Med. Devices 12(1), 011008 (Jan 19, 2018) (7 pages) Paper No: MED-17-1271; doi: 10.1115/1.4038498 History: Received July 21, 2017; Revised November 07, 2017

Retransfusion of a patient's own shed blood during cardiac surgery is attractive since it reduces the need for allogeneic transfusion, minimizes cost, and decreases transfusion related morbidity. Evidence suggests that lipid micro-emboli associated with the retransfusion of the shed blood are the predominant causes of the neurocognitive disorders. We have developed a novel acoustophoretic filtration system that can remove lipids from blood at clinically relevant flow rates. Unlike other acoustophoretic separation systems, this ultrasound technology works at the macroscale, and is therefore able to process larger flow rates than typical micro-electromechanical system (MEMS) scale acoustophoretic separation devices. In this work, we have first demonstrated the systematic design of the acoustic device and its optimization, followed by examining the feasibility of the device to filter lipids from the system. Then, we demonstrate the effects of the acoustic waves on the shed blood; examining hemolysis using both haptoglobin formation and lactate dehydrogenase release, as well as the potential of platelet aggregation or inflammatory cascade activation. Finally, in a porcine surgical model, we determined the potential viability of acoustic trapping as a blood filtration technology, as the animal responded to redelivered blood by increasing both systemic and mean arterial blood pressure.

FIGURES IN THIS ARTICLE
<>
Copyright © 2018 by ASME
Your Session has timed out. Please sign back in to continue.

References

Murphy, G. J. , and Angelini, G. D. , 2006, “ Indications for Blood Transfusion in Cardiac Surgery,” Ann. Thorac. Surg., 82(6), pp. 2323–2334. [CrossRef] [PubMed]
Jonsson, H. , Holm, C. , Nilsson, A. , Petersson, F. , Johnsson, P. , and Laurell, T. , 2004, “ Particle Separation Using Ultrasound Can Radically Reduce Embolic Load to Brain After Cardiac Surgery,” Ann. Thorac. Surg., 78(5), pp. 1572–1577. [CrossRef] [PubMed]
Kincaid, E. H. , Jones, T. J. , Stump, D. A. , Brown, W. R. , Moody, D. M. , Deal, D. D. , and Hammon, J. W., Jr. , 2000, “ Processing Scavenged Blood With a Cell Saver Reduces Cerebral Lipid Microembolization,” Ann. Thorac. Surg., 70(4), pp. 1296–1300. [CrossRef] [PubMed]
Bronden, B. , Dencker, M. , Allers, M. , Plaza, I. , and Jonsson, H. , 2006, “ Differential Distribution of Lipid Microemboli After Cardiac Surgery,” Ann. Thorac. Surg., 81(2), pp. 643–648. [CrossRef] [PubMed]
Brooker, R. F. , Brown, W. R. , Moody, D. M. , Hammon , J. W., Jr. , Reboussin, D. M. , Deal, D. D. , Ghazi-Birry, H. S. , and Stump, D. A. , 1998, “ Cardiotomy Suction: A Major Source of Brain Lipid Emboli During Cardiopulmonary Bypass,” Ann. Thorac. Surg., 65(6), pp. 1651–1655. [CrossRef] [PubMed]
de Vries, A. J. , Gu, Y. J. , Douglas, Y. L. , Post, W. J. , Lip, H. , and van Oeveren, W. , 2004, “ Clinical Evaluation of a New Fat Removal Filter During Cardiac Surgery,” Eur. J. Cardiothorac. Surg., 25(2), pp. 261–266. [CrossRef] [PubMed]
Eyjolfsson, A. , Scicluna, S. , Johnsson, P. , Petersson, F. , and Jonsson, H. , 2008, “ Characterization of Lipid Particles in Shed Mediastinal Blood,” Ann. Thorac. Surg., 85(3), pp. 978–981. [CrossRef] [PubMed]
Dell'Amore, A. , Tripodi, A. , Cavallucci, A. , Guerrini, F. , Ronchi, B. , Zanoni, S. , and Lamarra, M. , 2010, “ Efficacy of a New Oxygenator-Integrated Fat and Leukocyte Removal Device,” Asian Cardiovasc. Thorac. Ann., 18(6), pp. 546–550. [CrossRef] [PubMed]
Jewell, A. E. , Akowuah, E. F. , Suvarna, S. K. , Braidley, P. , Hopkinson, D. , and Cooper, G. , 2003, “ A Prospective Randomised Comparison of Cardiotomy Suction and Cell Saver for Recycling Shed Blood During Cardiac Surgery,” Eur. J. Cardiothorac. Surg., 23(4), pp. 633–636. [CrossRef] [PubMed]
Petersson, F. , Nilsson, A. , Holm, C. , Jonsson, H. , and Laurell, T. , 2005, “ Continuous Separation of Lipid Particles From Erythrocytes by Means of Laminar Flow and Acoustic Standing Wave Forces,” Lab Chip, 5(1), pp. 20–22. [CrossRef] [PubMed]
Gor'kov, L. P. , 1962, “ On the Forces Acting on a Small Particle in an Acoustical Field in an Ideal Fluid,” Sov. Phys. Dokl., 6, pp. 773–775.
Dutra, B. , Rust, M. , Kennedy, D. , Masi, L. , and Lipkens, B. , 2013, “ Macro-Scale Acoustophoretic Separation of Lipid Particles From Red Blood Cells,” Proc. Meet. Acoust., 19(1), p. 045017.
Ai, Y. , Sanders, C. K. , and Marrone, B. L. , 2013, “ Separation of Escherichia Coli Bacteria From Peripheral Blood Mononuclear Cells Using Standing Surface Acoustic Waves,” Anal. Chem., 85(19), pp. 9126–9134. [CrossRef] [PubMed]
Antfolk, M. , Magnusson, C. , Augustsson, P. , Lilja, H. , and Laurell, T. , 2015, “ Acoustofluidic, Label-Free Separation and Simultaneous Concentration of Rare Tumor Cells From White Blood Cells,” Anal. Chem., 87(18), pp. 9322–9328. [CrossRef] [PubMed]
Tenje, M. , Lundgren, M. N. , Sward-Nilsson, A. M. , Kjeldsen-Kragh, J. , Lyxe, L. , and Lenshof, A. , 2015, “ Acoustophoretic Removal of Proteins From Blood Components,” Biomed. Microdevices, 17(5), p. 95. [CrossRef] [PubMed]
Reents, W. , Babin-Ebell, J. , Misoph, M. R. , Schwarzkopf, A. , and Elert, O. , 1999, “ Influence of Different Autotransfusion Devices on the Quality of Salvaged Blood,” Ann. Thorac. Surg., 68(1), pp. 58–62. [CrossRef] [PubMed]
Bortz, D. M. , Jackson, T. L. , Taylor, K. A. , Thompson, A. P. , and Younger, J. G. , 2008, “ Klebsiella Pneumoniae Flocculation Dynamics,” Bull. Math. Biol., 70(3), pp. 745–768. [CrossRef] [PubMed]
Chung, H. M. , Cartwright, M. M. , Bortz, D. M. , Jackson, T. L. , and Younger, J. G. , 2008, “ Dynamical System Analysis of Staphylococcus Epidermidis Bloodstream Infection,” Shock, 30(5), pp. 518–526. [CrossRef] [PubMed]
Bracho, D. O. , Barsan, L. , Arekapudi, S. R. , Thompson, J. A. , Hen, J. , Stern, S. A. , and Younger, J. G. , 2009, “ Antibacterial Properties of an Iron-Based Hemostatic Agent In Vitro and in a Rat Wound Model,” Acad. Emerg. Med., 16(7), pp. 656–660. [CrossRef] [PubMed]
Yu, M. , Stott, S. , Toner, M. , Maheswaran, S. , and Haber, D. A. , 2011, “ Circulating Tumor Cells: Approaches to Isolation and Characterization,” J. Cell Biol., 192(3), pp. 373–382. [CrossRef] [PubMed]
Augustsson, P. , Magnusson, C. , Nordin, M. , Lilja, H. , and Laurell, T. , 2012, “ Microfluidic, Label-Free Enrichment of Prostate Cancer Cells in Blood Based on Acoustophoresis,” Anal. Chem., 84(18), pp. 7954–7962. [CrossRef] [PubMed]

Figures

Grahic Jump Location
Fig. 1

Schematic of the process. (a) Top view of system shows RBCs (dark circles) and shed blood lipid particles (light circles) entering the system and flowing horizontally. A standing wave establishes pressure node (solid) and antinode (dashed) planes in the center. (b) The axial component of the acoustic radiation force (ARF) aligns particles to nodes/antinodes based on positive/negative contrast factor. (c) The lateral component of the ARF clumps the particles within the planes to create striated columns. (d) Looking at the cross section of a nodal plane, RBCs sink together as clumps to a collector on the bottom. In an antinodal plane, lipid particles do the same and rise out.

Grahic Jump Location
Fig. 2

The lipid suspension was analyzed under a microscope with 40× magnification during multiple steps of the process: (a) lipid particles in saline immediately after spike (scale in image B applies to A–D as well), (b) lipid particles in saline after filtration through LipiGuard® SB filter, (c) lipid particles in saline after acoustic filtration in filtrate, (d) lipid particles in saline in lipid-collecting port, and (e) top view on the lipid-collecting port at the end of filtration

Grahic Jump Location
Fig. 3

Performance of the acoustic system processing 500 mL of a ten-fold diluted porcine blood at different inflow rates and ratios of outflow rates. The percent of cells collected and concentration factor are presented in the middle and right images, respectively.

Grahic Jump Location
Fig. 4

The hemolysis measurements obtained after acoustic processing of blood by haptoglobin (on the left) and LDH (on the right), n = 3–4

Grahic Jump Location
Fig. 5

Examination of potential negative effects of blood processing. The potential of arteriole clot formation was examined by (a) platelet aggregation and (b) the ability of platelets to activate was subsequently verified. (c) The potential of venous clot formation was measured by examining for fibrin degradation products. Finally, the potential for the activation of inflammatory pathways (d) was measured using an ELISA to measure interleukin 6 (on the left) and TNF—a levels (on the right).

Grahic Jump Location
Fig. 6

Examination of the effects of retransfusion of acoustically processed blood on both SBP and MAP. Data from both of the pigs (799 and 800) are shown.

Tables

Errata

Discussions

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging and repositioning the boxes below.

Related Journal Articles
Related eBook Content
Topic Collections

Sorry! You do not have access to this content. For assistance or to subscribe, please contact us:

  • TELEPHONE: 1-800-843-2763 (Toll-free in the USA)
  • EMAIL: asmedigitalcollection@asme.org
Sign In